Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease

TLDR

Guidelines for diagnosing and treating GERD, first published in 1995 and updated in 1999, are periodically reviewed and define GERD as symptoms or mucosal damage caused by abnormal gastric reflux into the esophagus. The purpose is to review and revise prior guideline statements in light of ongoing advances in GERD and to discuss refractory cases and future research needs. The guidelines were developed by the American College of Gastroenterology’s Practice Parameters Committee, covering diagnostics—empiric therapy, endoscopy, reflux monitoring, and manometry—and treatments including lifestyle changes, OTC therapy, acid suppression, promotility, maintenance, surgery, and endoscopic interventions.

Abstract

Guidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published in 1995 and updated in 1999. These and other guidelines undergo periodic review. Advances continue to be made in the area of GERD, leading us to review and revise previous guideline statements. GERD is defined as symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus. These guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. Diagnostic guidelines address empiric therapy and the use of endoscopy, ambulatory reflux monitoring, and esophageal manometry in GERD. Treatment guidelines address the role of lifestyle changes, patient directed (OTC) therapy, acid suppression, promotility therapy, maintenance therapy, antireflux surgery, and endoscopic therapy in GERD. Finally, there is a discussion of the rare patient with refractory GERD and a list of areas in need of additional study.