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. 2019 Oct;38(5):411-440.
doi: 10.1007/s12664-019-00979-y. Epub 2019 Dec 5.

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

Shobna J Bhatia  1 , Govind K Makharia  2 , Philip Abraham  3 , Naresh Bhat  4 , Ajay Kumar  5 , D Nageshwar Reddy  6 , Uday C Ghoshal  7 , Vineet Ahuja  2 , G Venkat Rao  6 , Krishnadas Devadas  8 , Amit K Dutta  9 , Abhinav Jain  10 , Saurabh Kedia  2 , Rohit Dama  6 , Rakesh Kalapala  6 , Jose Filipe Alvares  11 , Sunil Dadhich  12 , Vinod Kumar Dixit  13 , Mahesh Kumar Goenka  14 , B D Goswami  15 , Sanjeev K Issar  16 , Venkatakrishnan Leelakrishnan  17 , Mohandas K Mallath  18 , Philip Mathew  19 , Praveen Mathew  20 , Subhashchandra Nandwani  21 , Cannanore Ganesh Pai  22 , Lorance Peter  23 , A V Siva Prasad  24 , Devinder Singh  25 , Jaswinder Singh Sodhi  26 , Randhir Sud  27 , Jayanthi Venkataraman  28 , Vandana Midha  29 , Amol Bapaye  30 , Usha Dutta  31 , Ajay K Jain  32 , Rakesh Kochhar  31 , Amarender S Puri  33 , Shivram Prasad Singh  34 , Lalit Shimpi  35 , Ajit Sood  29 , Rajkumar T Wadhwa  36
Affiliations

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

Shobna J Bhatia et al. Indian J Gastroenterol. 2019 Oct.

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.

Keywords: Barrett’s esophagus; Esophageal manometry; Esophageal pH monitoring; Proton pump inhibitors.

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