Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology

Shobna J. Bhatia, Govind K. Makharia, Philip Abraham, Naresh Bhat, Ajay Kumar, D. Nageshwar Reddy, Uday C. Ghoshal, Vineet Ahuja, G. Venkat Rao, Krishnadas Devadas, Amit K. Dutta, Abhinav Jain, Saurabh Kedia, Rohit Dama, Rakesh Kalapala, Jose Filipe Alvares, Sunil Dadhich, Vinod Kumar Dixit, Mahesh Kumar Goenka, B. D. GoswamiSanjeev K. Issar, Venkatakrishnan Leelakrishnan, Mohandas K. Mallath, Philip Mathew, Praveen Mathew, Subhashchandra Nandwani, Cannanore Ganesh Pai, Lorance Peter, A. V.Siva Prasad, Devinder Singh, Jaswinder Singh Sodhi, Randhir Sud, Jayanthi Venkataraman, Vandana Midha, Amol Bapaye, Usha Dutta, Ajay K. Jain, Rakesh Kochhar, Amarender S. Puri, Shivram Prasad Singh, Lalit Shimpi, Ajit Sood, Rajkumar T. Wadhwa

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

The Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The prevalence of GERD in India ranges from 7.6% to 30%, being < 10% in most population studies, and higher in cohort studies. The dietary factors associated with GERD include use of spices and non-vegetarian food. Helicobacter pylori is thought to have a negative relation with GERD; H. pylori negative patients have higher grade of symptoms of GERD and esophagitis. Less than 10% of GERD patients in India have erosive esophagitis. In patients with occasional or mild symptoms, antacids and histamine H2 receptor blockers (H2RAs) may be used, and proton pump inhibitors (PPI) should be used in patients with frequent or severe symptoms. Prokinetics have limited proven role in management of GERD.

Original languageEnglish
Pages (from-to)411-440
Number of pages30
JournalIndian Journal of Gastroenterology
Volume38
Issue number5
DOIs
Publication statusPublished - 01-10-2019

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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