API-ISG Consensus Guidelines for Management of Gastrooesophageal Reflux Disease

Area of Science:

• Gastroenterology
• Internal Medicine
• Public Health

Background:

• Gastroesophageal reflux disease (GERD) is a prevalent community health issue.
• Lifestyle changes and rising obesity rates in India are contributing to an increase in GERD prevalence.
• Existing guidelines are crucial for standardized GERD management.

Purpose of the Study:

• To establish evidence-based practice guidelines for adult GERD management in India.
• To provide consensus statements on GERD epidemiology, presentation, investigation, treatment, and complications.
• To offer a framework for healthcare professionals managing GERD patients.

Main Methods:

• A modified Delphi process involving electronic voting and face-to-face meetings.
• Review of supporting literature, with a primary focus on Indian studies.
• Development of 43 consensus statements covering various aspects of GERD.

Main Results:

• GERD prevalence in India is approximately 10%, with an upward trend.
• Diagnosis in the community should primarily be based on classical symptoms (heartburn, sour regurgitation).
• Empiric treatment with proton pump inhibitors (PPIs) or H2 receptor antagonists is recommended; equipotent PPI doses show similar efficacy.

Conclusions:

• Community diagnosis of GERD should prioritize symptom-based assessment and empiric treatment.
• Proton pump inhibitors are effective for GERD symptom management.
• Invasive investigations are indicated only for patients with alarm symptoms or PPI-refractory GERD.