RESUMO
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.
Assuntos
Gastroenterologia/normas , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/terapia , Guias de Prática Clínica como Assunto , Adulto , Antiácidos/uso terapêutico , Consenso , Dieta/efeitos adversos , Esofagite/epidemiologia , Esofagite/etiologia , Feminino , Refluxo Gastroesofágico/etiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Índia/epidemiologia , Masculino , Prevalência , Inibidores da Bomba de Prótons/uso terapêutico , Sociedades MédicasRESUMO
In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.