Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bhatia SJ, Reddy DN, Ghoshal UC, et al. Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2011;30:118–27.

    PubMed  Google Scholar 

  2. Chowdhury SD, George G, Ramakrishna K, et al. Prevalence and factors associated with gastroesophageal reflux disease in southern India: a community-based study. Indian J Gastroenterol. 2019;38:77–82.

    PubMed  Google Scholar 

  3. Wang HY, Leena KB, Plymoth A, et al. Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India. BMC Gastroenterol. 2016;16:36.

    PubMed  PubMed Central  Google Scholar 

  4. Kumar S, Sharma S, Norboo T, et al. Population based study to assess prevalence and risk factors of gastroesophageal reflux disease in a high altitude area. Indian J Gastroenterol. 2011;30:135–43.

    CAS  PubMed  Google Scholar 

  5. Amarapurkar AD, Vora IM, Dhawan PS. Barrett’s esophagus. Indian J Pathol Microbiol. 1998;41:431–5.

    CAS  PubMed  Google Scholar 

  6. Linstone H, Turoff M. The Delphi method: techniques and application http://www.is.njit.edu/pubs/delphibook/. Accessed 15 Aug 2012.

  7. Periodic health examination: 2. 1984 update. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J. 1984;130:1278–85.

    Google Scholar 

  8. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus G. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20.

    PubMed  Google Scholar 

  9. Sharma PK, Ahuja V, Madan K, Gupta S, Raizada A, Sharma MP. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India. Indian J Gastroenterol. 2011;30:128–34.

    PubMed  Google Scholar 

  10. Bhalaghuru CM, Vijaya S, Jayanthi V. Symptomatic gastroesophageal reflux amongst hospital personnel in South India. Indian J Med Sci. 2011;65:355–9.

    CAS  PubMed  Google Scholar 

  11. Bhatia S, Gupta D, Vennalaganti P. Epidemiology of gastroesophageal reflux in Asia. The rise of acid reflux in Asia. J Neurogastroenterol Motil. 2017;17:14–27.

    Google Scholar 

  12. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63:871–80.

    PubMed  Google Scholar 

  13. Eusebi LH, Ratnakumaran R, Yuan Y, Solaymani-Dodaran M, Bazzoli F, Ford AC. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut. 2018;67:430–40.

    PubMed  Google Scholar 

  14. Chang P, Friedenberg F. Obesity and GERD. Gastroenterol Clin N Am. 2014;43:161–73.

    Google Scholar 

  15. Vaishnav B, Bamanikar A, Maske P, Reddy A, Dasgupta S. Gastroesophageal reflux disease and its association with body mass index: clinical and endoscopic study. J Clin Diagn Res. 2017;11:OC01–4.

    PubMed  PubMed Central  Google Scholar 

  16. National Nutrition Monitoring Bureau, NNMB Technical Report No. 26, Diet and nutritional status of rural population, prevalence of hypertension & diabetes among adults and infant & young child feeding practices, Report of Third Repeat Survey National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India – 2012. Available at: http://nnmbindia.org. Accessed 08 May 2019.

  17. Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101:2619–28.

    PubMed  Google Scholar 

  18. Këlliçi I, Kraja B. Smoking, alcohol, physical activity and gastroesophageal reflux disease: a literature review and the Albanian experience. Albanian Medical Journal. 2014;4:91–8.

    Google Scholar 

  19. Sethi S, Richter JE. Diet and gastroesophageal reflux disease: role in pathogenesis and management. Curr Opin Gastroenterol. 2017;33:107–11.

    PubMed  Google Scholar 

  20. Arivan R, Deepanjali S. Prevalence and risk factors of gastro-esophageal reflux disease among undergraduate medical students from a southern Indian medical school: a cross-sectional study. BMC Res Notes. 2018;11:448.

  21. Kim J, Oh SW, Myung SK, et al. Association between coffee intake and gastroesophageal reflux disease: a meta-analysis. Dis Esophagus. 2014;27:311–7.

    CAS  PubMed  Google Scholar 

  22. Ghoshal UC, Chourasia D. Gastroesophageal reflux disease and Helicobacter pylori: what may be the relationship? J Neurogastroenterol Motil. 2010;16:243–50.

    PubMed  PubMed Central  Google Scholar 

  23. Goh KL. Gastroesophageal reflux disease in Asia: a historical perspective and present challenges. J Gastroenterol Hepatol. 2011;26 Suppl 1:2–10.

    PubMed  Google Scholar 

  24. Peng S, Cui Y, Xiao YL, et al. Prevalence of erosive esophagitis and Barrett’s esophagus in the adult Chinese population. Endoscopy. 2009;41:1011–7.

    CAS  PubMed  Google Scholar 

  25. Nam SY, Choi IJ, Ryu KH, Kim BC, Kim CG, Nam BH. Effect of Helicobacter pylori infection and its eradication on reflux esophagitis and reflux symptoms. Am J Gastroenterol. 2010;105:2153–62.

    PubMed  Google Scholar 

  26. Gerson LB, Kahrilas PJ, Fass R. Insights into gastroesophageal reflux disease-associated dyspeptic symptoms. Clin Gastroenterol Hepatol. 2011;9:824–33.

    PubMed  Google Scholar 

  27. Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008;27:22–8.

    PubMed  Google Scholar 

  28. Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012;107:1793–801.

    PubMed  Google Scholar 

  29. Fock KM, Talley N, Goh KL, et al. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett’s oesophagus. Gut. 2016;65:1402–15.

    PubMed  Google Scholar 

  30. Richter JE, Rubenstein JH. Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology. 2018;154:267–76.

    PubMed  Google Scholar 

  31. Baruah B, Kumar T, Das P, et al. Prevalence of eosinophilic esophagitis in patients with gastroesophageal reflux symptoms: a cross-sectional study from a tertiary care hospital in North India. Indian J Gastroenterol. 2017;36:353–60.

    PubMed  Google Scholar 

  32. Irvine EJ. Quality of life assessment in gastro-oesophageal reflux disease. Gut. 2004;53 Suppl 4:iv35–9.

    PubMed  PubMed Central  Google Scholar 

  33. Quigley EM, Hungin AP. Review article: quality-of-life issues in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2005;22 Suppl 1:41–7.

    PubMed  Google Scholar 

  34. Becher A, El-Serag H. Systematic review: The association between symptomatic response to proton pump inhibitors and health-related quality of life in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34:618–27.

    CAS  PubMed  Google Scholar 

  35. Bitnar P, Stovicek J, Andel R, et al. Leg raise increases pressure in lower and upper esophageal sphincter among patients with gastroesophageal reflux disease. J Bodyw Mov Ther. 2016;20:518–24.

    CAS  PubMed  Google Scholar 

  36. Sodhi JS, Zargar SA, Javid G, et al. Effect of bending exercise on gastroesophageal reflux in symptomatic patients. Indian J Gastroenterol. 2008;27:227–31.

    PubMed  Google Scholar 

  37. Khan BA, Sodhi JS, Zargar SA, et al. Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. J Gastroenterol Hepatol. 2012;27:1078–82.

    PubMed  Google Scholar 

  38. Allampati S, Lopez R, Thota PN, Ray M, Birgisson S, Gabbard SL. Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms. Dis Esophagus. 2017;30:1–7.

    CAS  PubMed  Google Scholar 

  39. Hamilton JW, Boisen RJ, Yamamoto DT, Wagner JL, Reichelderfer M. Sleeping on a wedge diminishes exposure of the esophagus to refluxed acid. Dig Dis Sci. 1988;33:518–22.

    CAS  PubMed  Google Scholar 

  40. Pollmann H, Zillessen E, Pohl J, et al. Effect of elevated head position in bed in therapy of gastroesophageal reflux. Z Gastroenterol. 1996;34 Suppl 2:93–9.

    PubMed  Google Scholar 

  41. van Herwaarden MA, Katzka DA, Smout AJ, Samsom M, Gideon M, Castell DO. Effect of different recumbent positions on postprandial gastroesophageal reflux in normal subjects. Am J Gastroenterol. 2000;95:2731–6.

    PubMed  Google Scholar 

  42. Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol. 1999;94:2069–73.

    CAS  PubMed  Google Scholar 

  43. Orr WC. Sleep and gastroesophageal reflux: what are the risks? Am J Med. 2003;115:109–3S.

    Google Scholar 

  44. Shoenut JP, Yamashiro Y, Orr WC, Kerr P, Micflikier AB, Kryger MH. Effect of severe gastroesophageal reflux on sleep stage in patients with a peristaltic esophagus. Dig Dis Sci. 1996;41:372–6.

    CAS  PubMed  Google Scholar 

  45. Freidin N, Fisher MJ, Taylor W, et al. Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis. Gut. 1991;32:1275–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Ramu B, Mohan P, Rajasekaran MS, Jayanthi V. Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol. 2011;30:144–7.

    PubMed  Google Scholar 

  47. Gaddam S, Maddur H, Wani S, et al. Risk factors for nocturnal reflux in a large GERD cohort. J Clin Gastroenterol. 2011;45:764–8.

    PubMed  Google Scholar 

  48. Ghoshal UC, Chourasia D, Tripathi S, Misra A, Singh K. Relationship of severity of gastroesophageal reflux disease with gastric acid secretory profile and esophageal acid exposure during nocturnal acid breakthrough: a study using 24-h dual-channel pH-metry. Scand J Gastroenterol. 2008;43:654–61.

    PubMed  Google Scholar 

  49. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308–28.

    PubMed  Google Scholar 

  50. Niu XP, Yu BP, Wang YD, et al. Risk factors for proton pump inhibitor refractoriness in Chinese patients with non-erosive reflux disease. World J Gastroenterol. 2013;19:3124–9.

    PubMed  PubMed Central  Google Scholar 

  51. Lee ES, Kim N, Lee SH, et al. Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non-erosive reflux disease. Aliment Pharmacol Ther. 2009;30:154–64.

    CAS  PubMed  Google Scholar 

  52. Bytzer P, van Zanten SV, Mattsson H, et al. Partial symptom-response to proton pump inhibitors in patients with non-erosive reflux disease or reflux oesophagitis—a post hoc analysis of 5796 patients. Aliment Pharmacol Ther. 2012;36:635–43.

    CAS  PubMed  Google Scholar 

  53. Amarasiri DL, Pathmeswaran A, de Silva HJ, Ranasinha CD. Response of the airways and autonomic nervous system to acid perfusion of the esophagus in patients with asthma: a laboratory study. BMC Pulm Med. 2013;13:33.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Stein MR. Possible mechanisms of influence of esophageal acid on airway hyperresponsiveness. Am J Med. 2003;115 Suppl 3A:55S–9S.

    CAS  PubMed  Google Scholar 

  55. Schan CA, Harding SM, Haile JM, Bradley LA, Richter JE. Gastroesophageal reflux-induced bronchoconstriction. An intraesophageal acid infusion study using state-of-the-art technology. Chest. 1994;106:731–7.

    CAS  PubMed  Google Scholar 

  56. Ates F, Vaezi MF. Insight into the relationship between gastroesophageal reflux disease and asthma. Gastroenterol Hepatol. 2014;10:729–36.

    Google Scholar 

  57. Sandur V, Murugesh M, Banait V, et al. Prevalence of gastro-esophageal reflux disease in patients with difficult to control asthma and effect of proton pump inhibitor therapy on asthma symptoms, reflux symptoms, pulmonary function and requirement for asthma medications. J Postgrad Med. 2014;60:282–6.

    CAS  PubMed  Google Scholar 

  58. Charles S, Johnson P, Padmavathi R, Rajagopalan, Subhashini AS, Kumar AP. The prevalence of the gastro oesophageal reflux disease in asthmatics. J Clin Diagn Res. 2011;5:711–3.

    Google Scholar 

  59. Rameschandra S, Acharya V, Kunal VT, Ramkrishna A, Acharya P. Prevalence and spectrum of gastro esophageal reflux disease in bronchial asthma. J Clin Diagn Res. 2015;9:OC11–4.

    PubMed  PubMed Central  Google Scholar 

  60. Smith J, Woodcock A, Houghton L. New developments in reflux-associated cough. Lung. 2010;188 Suppl 1:S81–6.

    PubMed  Google Scholar 

  61. Woodcock A, Young EC, Smith JA. New insights in cough. Br Med Bull. 2010;96:61–73.

    PubMed  Google Scholar 

  62. Smith J, Decalmer S, Kelsall A, et al. Acoustic cough-reflux associations in chronic cough: potential triggers and mechanisms. Gastroenterology. 2010;139:754–62.

    PubMed  Google Scholar 

  63. Pore R, Biswas S, Das S. Prevailing practices for the management of dry cough in India: a questionnaire based survey. J Assoc Physicians India. 2016;64:48–54.

    PubMed  Google Scholar 

  64. Kahrilas PJ, Smith JA, Dicpinigaitis PV. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate. Lung. 2014;192:39–46.

    PubMed  Google Scholar 

  65. Ford CN. Evaluation and management of laryngopharyngeal reflux. JAMA. 2005;294:1534–40.

    CAS  PubMed  Google Scholar 

  66. Maldhure S, Chandrasekharan R, Dutta AK, Chacko A, Kurien M. Role of pH monitoring in laryngopharyngeal reflux patients with voice disorders. Iran J Otorhinolaryngol. 2016;28:377–83.

    PubMed  PubMed Central  Google Scholar 

  67. Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope. 2001;111:1313–7.

    CAS  PubMed  Google Scholar 

  68. Hicks DM, Ours TM, Abelson TI, Vaezi MF, Richter JE. The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J Voice. 2002;16:564–79.

    PubMed  Google Scholar 

  69. Campagnolo AM, Priston J, Thoen RH, Medeiros T, Assunção AR. Laryngopharyngeal reflux: diagnosis, treatment, and latest research. Int Arch Otorhinolaryngol. 2014;18:184–91.

    PubMed  Google Scholar 

  70. Fass R, Achem SR. Noncardiac chest pain: epidemiology, natural course and pathogenesis. J Neurogastroenterol Motil. 2011;17:110–23.

    PubMed  PubMed Central  Google Scholar 

  71. Stahl WG, Beton RR, Johnson CS, Brown CL, Waring JP. Diagnosis and treatment of patients with gastroesophageal reflux and non cardiac chest pain. South Med J. 1994;87:739–42.

    CAS  PubMed  Google Scholar 

  72. Jain M. Evaluation of noncardiac chest pain in Indian setting—can we reduce the investigation burden? Indian J Gastroenterol. 2015;34:266–7.

    PubMed  Google Scholar 

  73. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166:965–71.

    PubMed  Google Scholar 

  74. Fan W, Hou Y, Sun X, et al. Effects of high-fat, standard, and functional food meals on esophageal and gastric pH in patients with gastroesophageal reflux disease and healthy subjects. J Dig Dis. 2018;19:664–73.

    PubMed  Google Scholar 

  75. Wu KL, Kuo CM, Yao CC, et al. The effect of dietary carbohydrate on gastroesophageal reflux disease. J Formos Med Assoc. 2018;117:973–8.

    PubMed  Google Scholar 

  76. Shapiro M, Green C, Bautista JM, et al. Assessment of dietary nutrients that influence perception of intra-oesophageal acid reflux events in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2007;25:93–101.

    CAS  PubMed  Google Scholar 

  77. Dent J, Vakil N, Jones R, et al. Accuracy of the diagnosis of GORD by questionnaire, physicians and a trial of proton pump inhibitor treatment: the Diamond Study. Gut. 2010;59:714–21.

    PubMed  Google Scholar 

  78. Hunt R, Armstrong D, Katelaris P, et al. World Gastroenterology Organisation global guidelines: GERD global perspective on gastroesophageal reflux disease. J Clin Gastroenterol. 2017;51:467–78.

    PubMed  Google Scholar 

  79. Gasiorowska A, Fass R. The proton pump inhibitor (PPI) test in GERD: does it still have a role? J Clin Gastroenterol. 2008;42:867–74.

    CAS  PubMed  Google Scholar 

  80. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  81. Dent J. Endoscopic grading of reflux oesophagitis: the past, present and future. Best Pract Res Clin Gastroenterol. 2008;22:585–99.

    PubMed  Google Scholar 

  82. Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol. 2004;16:495–501.

    PubMed  Google Scholar 

  83. Dutta AK, Chacko A, Balekuduru A, Sahu MK, Gangadharan SK. High prevalence of significant endoscopic findings in patients with uninvestigated typical reflux symptoms. Am J Gastroenterol. 2011;106:1172–3.

    PubMed  Google Scholar 

  84. Savarino E, Gemignani L, Pohl D, Zentilin P, Dulbecco P, Assandri L. Oesophageal motility and bolus transit abnormalities increase in parallel with the severity of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34:476–86.

    CAS  PubMed  Google Scholar 

  85. Kahrilas PJ, McColl K, Fox M, et al. The acid pocket: a target for treatment in reflux disease? Am J Gastroenterol. 2013;108:1058–64.

    CAS  PubMed  Google Scholar 

  86. Vaezi MF, Sifrim D. Assessing old and new diagnostic tests for gastroesophageal reflux disease. Gastroenterology. 2018;154:289–301.

    PubMed  Google Scholar 

  87. Dhawan PS, Alvares JF, Vora IM, et al. Prevalence of short segments of specialized columnar epithelium in distal esophagus: association with gastroesophageal reflux. Indian J Gastroenterol. 2001;20:144–7.

    CAS  PubMed  Google Scholar 

  88. Mathew P, Joshi AS, Shukla A, Bhatia SJ. Risk factors for Barrett's esophagus in Indian patients with gastroesophageal reflux disease. J Gastroenterol Hepatol. 2011;26:1151-6.

    PubMed  Google Scholar 

  89. Kao SS, Chen WC, Hsu PI, et al. The frequencies of gastroesophageal and extragastroesophageal symptoms in patients with mild erosive esophagitis, severe erosive esophagitis, and Barrett’s esophagus in Taiwan. Gastroenterol Res Pract. 2013;2013:480325.

    PubMed  PubMed Central  Google Scholar 

  90. Johnsson F, Joelsson B, Gudmundsson K, Greiff L. Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease. Scand J Gastroenterol. 1987;22:714–8.

    CAS  PubMed  Google Scholar 

  91. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon consensus. Gut. 2018;67:1351–62.

    PubMed  Google Scholar 

  92. Roman S, Gyawali CP, Savarino E, et al. GERD consensus group. Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: update of the Porto consensus and recommendations from an international consensus group. Neurogastroenterol Motil. 2017;29:1–15.

    CAS  PubMed  Google Scholar 

  93. Madan K, Ahuja V, Gupta SD, Bal C, Kapoor A, Sharma MP. Impact of 24-h esophageal pH monitoring on the diagnosis of gastroesophageal reflux disease: defining the gold standard. J Gastroenterol Hepatol. 2005;20:30–7.

    PubMed  Google Scholar 

  94. Prakash C, Clouse RE. Value of extended recording time with wireless pH monitoring in evaluating gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2005;3:329–34.

    PubMed  Google Scholar 

  95. Wong WM, Bautista J, Dekel R, et al. Feasibility and tolerability of transnasal/per-oral placement of the wireless pH capsule vs. traditional 24-h oesophageal pH monitoring—a randomized trial. Aliment Pharmacol Ther. 2005;21:155–63.

    PubMed  Google Scholar 

  96. Karyampudi A, Ghoshal UC, Singh R, Verma A, Misra A, Saraswat VA. Esophageal acidification during nocturnal acid-breakthrough with ilaprazole versus omeprazole in gastroesophageal reflux disease. J Neurogastroenterol Motil. 2017;23:208–17.

    PubMed  PubMed Central  Google Scholar 

  97. Weigt J, Kandulski A, Büsch F, Malfertheiner P. Nocturnal gastric acid breakthrough is not associated with night-time gastroesophageal reflux in GERD patients. Dig Dis. 2009;27:68–73.

    PubMed  Google Scholar 

  98. Jain M, Srinivas M, Bawane P, Venkataraman J. Basal lower esophageal sphincter pressure in gastroesophageal reflux disease: an ignored metric in high-resolution esophageal manometry. Indian J Gastroenterol. 2018;37:446–51.

    PubMed  Google Scholar 

  99. Patti MG, Diener U, Tamburini A, Molena D, Way LW. Role of esophageal function tests in diagnosis of gastroesophageal reflux disease. Dig Dis Sci. 2001;46:597–602.

    CAS  PubMed  Google Scholar 

  100. Spechler SJ, Souza RF, Rosenberg SJ, Ruben RA, Goyal RK. Heartburn in patients with achalasia. Gut. 1995;37:305–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  101. Chourasia D, Misra A, Tripathi S, Krishnani N, Ghoshal UC. Patients with Helicobacter pylori infection have less severe gastroesophageal reflux disease: a study using endoscopy, 24-hour gastric and esophageal pH metry. Indian J Gastroenterol. 2011;30:12–21.

    PubMed  Google Scholar 

  102. Pandit BB, Lahoti M, Amarapurkar AD, Kamath R, Naik AS, Bhatia SJ. Relationship between Helicobacter pylori and gastro-esophageal reflux disease. Indian J Gastroenterol. 2003;22 Suppl 1:A11.

    Google Scholar 

  103. Saleh CM, Smout AJ, Bredenoord AJ. The diagnosis of gastro-esophageal reflux disease cannot be made with barium esophagograms. Neurogastroenterol Motil. 2015;27:195–200.

    CAS  PubMed  Google Scholar 

  104. Rey JW, Deris N, Marquardt JU, et al. High-definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group. Dis Esophagus. 2016;29:185-91.

    CAS  PubMed  Google Scholar 

  105. Miyasaka M, Hirakawa M, Nakamura K, et al. The endoscopic diagnosis of nonerosive reflux disease using flexible spectral imaging color enhancement image: a feasibility trial. Dis Esophagus. 2011;24:395-400.

    CAS  PubMed  Google Scholar 

  106. Fock KM, Teo EK, Ang TL, et al. The utility of narrow band imaging in improving the endoscopic diagnosis of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2009;7:54–9.

    PubMed  Google Scholar 

  107. Sharma P, Wani S, Bansal A, et al. A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. Gastroenterology. 2007;133:454–64.

    PubMed  Google Scholar 

  108. Chu CL, Zhen YB, Lv GP, et al. Microalterations of esophagus in patients with non-erosive reflux disease: in-vivo diagnosis by confocal laser endomicroscopy and its relationship with gastroesophageal reflux. Am J Gastroenterol. 2012;107:864–74.

    PubMed  Google Scholar 

  109. Smeets FG, Keszthelyi D, Bouvy ND, Masclee AA, Conchillo JM. Does measurement of esophagogastric junction distensibility by EndoFLIP predict therapy-responsiveness to endoluminal fundoplication in patients with gastroesophageal reflux disease? J Neurogastroenterol Motil. 2015;21:255–64.

    PubMed  PubMed Central  Google Scholar 

  110. Chen JW, Rubenstein JH. Esophagogastric junction distensibility assessed using the functional lumen imaging probe. World J Gastroenterol. 2017;23:1289–97.

    PubMed  PubMed Central  Google Scholar 

  111. Price SF, Smithson KW, Castell DO. Food sensitivity in reflux esophagitis. Gastroenterology. 1978;75:240–3.

    CAS  PubMed  Google Scholar 

  112. Boekema PJ, Samsom M, Smout AJ. Effect of coffee on gastro-oesophageal reflux in patients with reflux disease and healthy controls. Eur J Gastroenterol Hepatol. 1999;11:1271–6.

    CAS  PubMed  Google Scholar 

  113. Wang J-H, Luo J-Y, Dong L, Gong J, Tong M. Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi’an of northwest China. World J Gastroenterol. 2004;10:1647–51.

    PubMed  PubMed Central  Google Scholar 

  114. Stanghellini V. Relationship between upper gastrointestinal symptoms and lifestyle, psychosocial factors and comorbidity in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol Suppl. 1999;231:29–37.

    CAS  PubMed  Google Scholar 

  115. Cohen S, Booth GH. Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine. N Engl J Med. 1975;293:897–9.

    CAS  PubMed  Google Scholar 

  116. Kahrilas PJ, Gupta RR. The effect of cigarette smoking on salivation and esophageal acid clearance. J Lab Clin Med. 1989;114:431–8.

    CAS  PubMed  Google Scholar 

  117. Watanabe Y, Fujiwara Y, Shiba M, et al. Cigarette smoking and alcohol consumption associated with gastro-oesophageal reflux disease in Japanese men. Scand J Gastroenterol. 2003;38:807–11.

    CAS  PubMed  Google Scholar 

  118. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut. 2004;53:1730–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  119. Schindlbeck NE, Heinrich C, Dendorfer A, Pace F, Müller-Lissner SA. Influence of smoking and esophageal intubation on esophageal pH-metry. Gastroenterology. 1987;92:1994–7.

    CAS  PubMed  Google Scholar 

  120. Waring JP, Eastwood TF, Austin JM, Sanowski RA. The immediate effects of cessation of cigarette smoking on gastroesophageal reflux. Am J Gastroenterol. 1989;84:1076–8.

    CAS  PubMed  Google Scholar 

  121. Kadakia SC, Kikendall JW, Maydonovitch C, Johnson LF. Effect of cigarette smoking on gastroesophageal reflux measured by 24-h ambulatory esophageal pH monitoring. Am J Gastroenterol. 1995;90:1785–90.

    CAS  PubMed  Google Scholar 

  122. Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Tobacco smoking cessation and improved gastroesophageal reflux: a prospective population-based cohort study: the HUNT study. Am J Gastroenterol. 2014;109:171–7.

    PubMed  Google Scholar 

  123. Bujanda L. The effects of alcohol consumption upon the gastrointestinal tract. Am J Gastroenterol. 2000;95:3374–82.

    CAS  PubMed  Google Scholar 

  124. Kaufman SE, Kaye MD. Induction of gastro-oesophageal reflux by alcohol. Gut. 1978;19:336–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  125. Ness-Jensen E, Hveem K, El-Serag H, Lagergren J. Lifestyle intervention in gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2016;14:175–82.

    PubMed  Google Scholar 

  126. Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006;354:2340–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  127. Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Weight loss and reduction in gastroesophageal reflux. A prospective population-based cohort study: the HUNT study. Am J Gastroenterol. 2013;108:376–82.

    PubMed  Google Scholar 

  128. Austin GL, Thiny MT, Westman EC, Yancy WS, Shaheen NJ. A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms. Dig Dis Sci. 2006;51:1307–12.

    CAS  PubMed  Google Scholar 

  129. Fraser-Moodie CA, Norton B, Gornall C, Magnago S, Weale AR, Holmes GK. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34:337–40.

    CAS  PubMed  Google Scholar 

  130. Mathus-Vliegen EM, Tygat GN. Gastro-oesophageal reflux in obese subjects: influence of overweight, weight loss and chronic gastric balloon distension. Scand J Gastroenterol. 2002;37:1246–52.

    CAS  PubMed  Google Scholar 

  131. Mathus-Vliegen LM, Tytgat GN. Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. Eur J Gastroenterol Hepatol. 1996;8:635–40.

    CAS  PubMed  Google Scholar 

  132. Mathus-Vliegen EM, van Weeren M, van Eerten PV. Los function and obesity: the impact of untreated obesity, weight loss, and chronic gastric balloon distension. Digestion. 2003;68:161–8.

    CAS  PubMed  Google Scholar 

  133. Singh M, Lee J, Gupta N, et al. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (Silver Spring). 2013;21:284–90.

    Google Scholar 

  134. Sharma A, Aggarwal S, Ahuja V, Bal C. Evaluation of gastroesophageal reflux before and after sleeve gastrectomy using symptom scoring, scintigraphy, and endoscopy. Surg Obes Relat Dis. 2014;10:600–5.

    PubMed  Google Scholar 

  135. Stanciu C, Bennett JR. Effects of posture on gastro-oesophageal reflux. Digestion. 1977;15:104–9.

    CAS  PubMed  Google Scholar 

  136. Piesman M, Hwang I, Maydonovitch C, Wong RK. Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? Am J Gastroenterol. 2007;102:2128–34.

    PubMed  Google Scholar 

  137. Lanzon-Miller S, Pounder RE, McIsaac RL, Wood JR. The timing of the evening meal affects the pattern of 24-hour intragastric acidity. Aliment Pharmacol Ther. 1990;4:547–53.

    CAS  PubMed  Google Scholar 

  138. Duroux P, Bauerfeind P, Emde C, Koelz HR, Blum AL. Early dinner reduces nocturnal gastric acidity. Gut. 1989;30:1063–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  139. Orr WC, Harnish MJ. Sleep-related gastro-oesophageal reflux: provocation with a late evening meal and treatment with acid suppression. Aliment Pharmacol Ther. 1998;12:1033–8.

    CAS  PubMed  Google Scholar 

  140. Tran T, Lowry AM, El-Serag HB. Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies. Aliment Pharmacol Ther. 2007;25:143–53.

    CAS  PubMed  Google Scholar 

  141. Surdea-Blaga T, Băncilă I, Dobru D, et al. Mucosal protective compounds in the treatment of gastroesophageal reflux disease. A position paper based on evidence of the Romanian Society of Neurogastroenterology. J Gastrointestin Liver Dis. 2016;25:537–46.

    PubMed  Google Scholar 

  142. Savarino E, Zentilin P, Marabotto E, et al. A review of pharmacotherapy for treating gastroesophageal reflux disease (GERD). Expert Opin Pharmacother. 2017;18:1333–43.

    CAS  PubMed  Google Scholar 

  143. Simon B, Ravelli GP, Goffin H. Sucralfate gel versus placebo in patients with non-erosive gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 1996;10:441–6.

    CAS  PubMed  Google Scholar 

  144. Wolfe MM, Sachs G. Acid suppression: optimizing therapy for gastroduodenal ulcer healing, gastroesophageal reflux disease, and stress-related erosive syndrome. Gastroenterology. 2000;118 2 Suppl 1:S9–31.

    CAS  PubMed  Google Scholar 

  145. Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME. Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease. Cochrane Database Syst Rev. 2013;5:CD002095.

    Google Scholar 

  146. Gyawali CP, Fass R. Management of gastroesophageal reflux disease. Gastroenterology. 2018;154:302–18.

    PubMed  Google Scholar 

  147. Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419–25.

    PubMed  Google Scholar 

  148. Numans ME, Lau J, de Wit NJ, Bonis PA. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. Ann Intern Med. 2004;140:518–27.

    CAS  PubMed  Google Scholar 

  149. Weijenborg PW, Cremonini F, Smout AJ, Bredenoord AJ. PPI therapy is equally effective in well-defined non-erosive reflux disease and in reflux esophagitis: a meta-analysis. Neurogastroenterol Motil. 2012;24:747–57.

    CAS  PubMed  Google Scholar 

  150. Bhatia S, Shukla A, Johnson D. An expert review and recommendations on the rational use of proton pump inhibitors: Indian perspective. J Assoc Physicians India. 2019;67:88-96.

  151. Zhang J-X, Ji M-Y, Song J, et al. Proton pump inhibitor for non-erosive reflux disease: a meta-analysis. World J Gastroenterol. 2013;19:8408–19.

    CAS  PubMed  PubMed Central  Google Scholar 

  152. Zhang H, Yang Z, Ni Z, Shi Y. A meta-analysis and systematic review of the efficacy of twice daily PPIs versus once daily for treatment of gastroesophageal reflux disease. Gastroenterol Res Pract. 2017;2017:9865963.

    PubMed  PubMed Central  Google Scholar 

  153. Chiba N, De Gara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology. 1997;112:1798–810.

    CAS  PubMed  Google Scholar 

  154. McDonagh MS, Carson S, Thakurta S. Drug class review: proton pump inhibitors: final report update 5 [internet]. Portland (OR): Oregon Health & Science University; 2009. (Drug Class Reviews). Available from: http://www.ncbi.nlm.nih.gov/books/NBK47260/

    Google Scholar 

  155. Delchier JC, Cohen G, Humphries TJ. Rabeprazole, 20 mg once daily or 10 mg twice daily, is equivalent to omeprazole, 20 mg once daily, in the healing of erosive gastrooesophageal reflux disease. Scand J Gastroenterol. 2000;35:1245–50.

    CAS  PubMed  Google Scholar 

  156. Kinoshita Y, Hongo M, Japan TWICE Study Group. Efficacy of twice-daily rabeprazole for reflux esophagitis patients refractory to standard once-daily administration of PPI: the Japan-based TWICE study. Am J Gastroenterol. 2012;107:522–30.

    CAS  PubMed  Google Scholar 

  157. Schindlbeck NE, Klauser AG, Berghammer G, Londong W, Müller-Lissner SA. Three year follow up of patients with gastrooesophageal reflux disease. Gut. 1992;33:1016–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  158. Inadomi JM, Jamal R, Murata GH, et al. Step-down management of gastroesophageal reflux disease. Gastroenterology. 2001;121:1095–100.

    CAS  PubMed  Google Scholar 

  159. Lind T, Havelund T, Lundell L, et al. On demand therapy with omeprazole for the long-term management of patients with heartburn without oesophagitis—a placebo-controlled randomized trial. Aliment Pharmacol Ther. 1999;13:907–14.

    CAS  PubMed  Google Scholar 

  160. Zacny J, Zamakhshary M, Sketris I, Veldhuyzen van Zanten S. Systematic review: The efficacy of intermittent and on-demand therapy with histamine H2-receptor antagonists or proton pump inhibitors for gastro-oesophageal reflux disease patients. Aliment Pharmacol Ther. 2005;21:1299–312.

    CAS  PubMed  Google Scholar 

  161. Pace F, Tonini M, Pallotta S, Molteni P, Porro GB. Systematic review: Maintenance treatment of gastro-oesophageal reflux disease with proton pump inhibitors taken “on-demand.”. Aliment Pharmacol Ther. 2007;26:195–204.

    CAS  PubMed  Google Scholar 

  162. Donnellan C, Sharma N, Preston C, Moayyedi P. Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease. Cochrane Database Syst Rev. 2005 Apr 18;2:CD003245.

    Google Scholar 

  163. Inadomi JM, McIntyre L, Bernard L, Fendrick AM. Step-down from multiple- to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs. Am J Gastroenterol. 2003;98:1940–4.

    CAS  PubMed  Google Scholar 

  164. Vigneri S, Termini R, Leandro G, et al. A comparison of five maintenance therapies for reflux esophagitis. N Engl J Med. 1995;333:1106–10.

    CAS  PubMed  Google Scholar 

  165. Gough AL, Long RG, Cooper BT, Fosters CS, Garrett AD, Langworthy CH. Lansoprazole versus ranitidine in the maintenance treatment of reflux oesophagitis. Aliment Pharmacol Ther. 1996;10:529–39.

    CAS  PubMed  Google Scholar 

  166. Mine S, Iida T, Tabata T, Kishikawa H, Tanaka Y. Management of symptoms in step-down therapy of gastroesophageal reflux disease. J Gastroenterol Hepatol. 2005;20:1365–70.

    CAS  PubMed  Google Scholar 

  167. Boghossian TA, Rashid FJ, Thompson W, et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev. 2017;3:CD011969.

    PubMed  Google Scholar 

  168. Jaspersen D, Schwacha H, Schorr W, Brennenstuhl M, Raschka C, Hammar CH. Omeprazole in the treatment of patients with complicated gastro-oesophageal reflux disease. J Gastroenterol Hepatol. 1996;11:900–2.

    CAS  PubMed  Google Scholar 

  169. Swarbrick ET, Gough AL, Foster CS, Christian J, Garrett AD, Langworthy CH. Prevention of recurrence of oesophageal stricture, a comparison of lansoprazole and high-dose ranitidine. Eur J Gastroenterol Hepatol. 1996;8:431–8.

    CAS  PubMed  Google Scholar 

  170. Smith PM, Kerr GD, Cockel R, et al. A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Invest Group. Gastroenterology. 1994;107:1312–8.

    CAS  PubMed  Google Scholar 

  171. Kuo B, Castell DO. Optimal dosing of omeprazole 40 mg daily: effects on gastric and esophageal pH and serum gastrin in healthy controls. Am J Gastroenterol. 1996;91:1532–8.

    CAS  PubMed  Google Scholar 

  172. Xue S, Katz PO, Banerjee P, Tutuian R, Castell DO. Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors. Aliment Pharmacol Ther. 2001;15:1351–6.

    CAS  PubMed  Google Scholar 

  173. Peghini PL, Katz PO, Bracy NA, Castell DO. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol. 1998;93:763–7.

    CAS  PubMed  Google Scholar 

  174. Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology. 1998;115:1335–9.

    CAS  PubMed  Google Scholar 

  175. Mainie I, Tutuian R, Castell DO. Addition of a H2 receptor antagonist to PPI improves acid control and decreases nocturnal acid breakthrough. J Clin Gastroenterol. 2008;42:676–9.

    CAS  PubMed  Google Scholar 

  176. Fackler WK, Ours TM, Vaezi MF, Richter JE. Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough. Gastroenterology. 2002;122:625–32.

    CAS  PubMed  Google Scholar 

  177. Ours TM, Fackler WK, Richter JE, Vaezi MF. Nocturnal acid breakthrough: clinical significance and correlation with esophageal acid exposure. Am J Gastroenterol. 2003;98:545–50.

    PubMed  Google Scholar 

  178. Dean BB, Gano AD, Knight K, Ofman JJ, Fass R. Effectiveness of proton pump inhibitors in nonerosive reflux disease. Clin Gastroenterol Hepatol. 2004;2:656–64.

    CAS  PubMed  Google Scholar 

  179. Gunaratnam NT, Jessup TP, Inadomi J, Lascewski DP. Sub-optimal proton pump inhibitor dosing is prevalent in patients with poorly controlled gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2006;23:1473–7.

    CAS  PubMed  Google Scholar 

  180. Fass R, Sontag SJ, Traxler B, Sostek M. Treatment of patients with persistent heartburn symptoms: a double-blind, randomized trial. Clin Gastroenterol Hepatol. 2006;4:50–6.

    CAS  PubMed  Google Scholar 

  181. Khan M, Santana J, Donnellan C, Preston C, Moayyedi P. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev. 2007;(2):CD003244.

  182. Madan K, Ahuja V, Kashyap PC, Sharma MP. Comparison of efficacy of pantoprazole alone versus pantoprazole plus mosapride in therapy of gastroesophageal reflux disease: a randomized trial. Dis Esophagus. 2004;17:274–8.

    CAS  PubMed  Google Scholar 

  183. Ren L-H, Chen W-X, Qian L-J, Li S, Gu M, Shi R-H. Addition of prokinetics to PPI therapy in gastroesophageal reflux disease: a meta-analysis. World J Gastroenterol. 2014;20:2412–9.

    PubMed  PubMed Central  Google Scholar 

  184. Kessing BF, Smout AJ, Bennink RJ, Kraaijpoel N, Oors JM, Bredenoord AJ. Prucalopride decreases esophageal acid exposure and accelerates gastric emptying in healthy subjects. Neurogastroenterol Motil. 2014;26:1079–86.

    CAS  PubMed  Google Scholar 

  185. Futagami S, Iwakiri K, Shindo T, et al. The prokinetic effect of mosapride citrate combined with omeprazole therapy improves clinical symptoms and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying. J Gastroenterol. 2010;45:413–21.

    CAS  PubMed  Google Scholar 

  186. Kamiya T, Adachi H, Hirako M, et al. Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease. J Gastroenterol. 2009;44:183–9.

    CAS  PubMed  Google Scholar 

  187. Giudicessi JR, Ackerman MJ, Camilleri M. Cardiovascular safety of prokinetic agents: a focus on drug-induced arrhythmias. Neurogastroenterol Motil. 2018;30:e13302.

    CAS  PubMed  PubMed Central  Google Scholar 

  188. Li S, Shi S, Chen F, Lin J. The effects of baclofen for the treatment of gastroesophageal reflux disease: a meta-analysis of randomized controlled trials. Gastroenterol Res Pract. 2014;2014:307805.

    PubMed  PubMed Central  Google Scholar 

  189. Kahrilas PJ, Boeckxstaens G, Smout AJ. Management of the patient with incomplete response to PPI therapy. Best Pract Res Clin Gastroenterol. 2013;27:401–14.

    PubMed  PubMed Central  Google Scholar 

  190. Vashani K, Murugesh M, Hattiangadi G, et al. Effectiveness of voice therapy in reflux-related voice disorders. Dis Esophagus. 2010;23:27-32.

    CAS  PubMed  Google Scholar 

  191. Gopal B, Singhal P, Gaur SN. Gastroesophageal reflux disease in bronchial asthma and the response to omeprazole. Asian Pac J Allergy Immunol. 2005;23:29–34.

  192. Kahrilas PJ, Hughes N, Howden CW. Response of unexplained chest pain to proton pump inhibitor treatment in patients with and without objective evidence of gastro-oesophageal reflux disease. Gut. 2011;60:1473–8.

    CAS  PubMed  Google Scholar 

  193. Irwin RS, Zawacki JK, Wilson MM, French CT, Callery MP. Chronic cough due to gastroesophageal reflux disease: failure to resolve despite total/near-total elimination of esophageal acid. Chest. 2002;121:1132–40.

    PubMed  Google Scholar 

  194. Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA. Gastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults. Cochrane Database Syst Rev. 2011;1:CD004823.

    Google Scholar 

  195. Gopal B, Singhal P, Gaur SN. Gastroesophageal reflux disease in bronchial asthma and the response to omeprazole. Asian Pac J Allergy Immunol. 2005;23:29–34.

    CAS  PubMed  Google Scholar 

  196. Harding SM, Richter JE, Guzzo MR, Schan CA, Alexander RW, Bradley LA. Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome. Am J Med. 1996;100:395–405.

    CAS  PubMed  Google Scholar 

  197. Kiljander TO, Salomaa ER, Hietanen EK, Terho EO. Gastroesophageal reflux in asthmatics: a double-blind, placebo-controlled crossover study with omeprazole. Chest. 1999;116:1257–64.

    CAS  PubMed  Google Scholar 

  198. Meier JH, McNally PR, Punja M, et al. Does omeprazole (Prilosec) improve respiratory function in asthmatics with gastroesophageal reflux? A double-blind, placebo-controlled crossover study. Dig Dis Sci. 1994;39:2127–33.

    CAS  PubMed  Google Scholar 

  199. American Lung Association Asthma Clinical Research Centers, Mastronarde JG, Anthonisen NR, et al. Efficacy of esomeprazole for treatment of poorly controlled asthma. N Engl J Med. 2009;360:1487–99.

    PubMed Central  Google Scholar 

  200. Littner MR, Leung FW, Ballard ED, Huang B, Samra NK, Lansoprazole Asthma Study Group. Effects of 24 weeks of lansoprazole therapy on asthma symptoms, exacerbations, quality of life, and pulmonary function in adult asthmatic patients with acid reflux symptoms. Chest. 2005;128:1128–35.

    CAS  PubMed  Google Scholar 

  201. Gralnek IM, Dulai GS, Fennerty MB, Spiegel BM. Esomeprazole versus other proton pump inhibitors in erosive esophagitis: a meta-analysis of randomized clinical trials. Clin Gastroenterol Hepatol. 2006;4:1452–8.

    CAS  PubMed  Google Scholar 

  202. Chen L, Chen Y, Li B. The efficacy and safety of proton-pump inhibitors in treating patients with non-erosive reflux disease: a network meta-analysis. Sci Rep. 2016;6:321–26.

  203. derp-ppi.pdf [Internet]. [cited 2019 Jan 23]. Available from: https://www2.gov.bc.ca/assets/gov/health/health-drug-coverage/pharmacare/derp-ppi.pdf

  204. Spechler SJ, Sharma P, Souza RF, et al. American Gastroenterological Association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–52.

    PubMed  Google Scholar 

  205. Johnson DA, Katz PO, Armstrong D, et al. The safety of appropriate use of over-the-counter proton pump inhibitors: an evidence-based review and Delphi consensus. Drugs. 2017;77:547–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  206. Scarpignato C, Gatta L, Zullo A, Blandizzi C, SIF-AIGO-FIMMG Group, Italian Society of Pharmacology, et al. Effective and safe proton pump inhibitor therapy in acid-related diseases—a position paper addressing benefits and potential harms of acid suppression. BMC Med. 2016;14:179.

  207. Kia L, Kahrilas PJ. Therapy: risks associated with chronic PPI use—signal or noise? Nat Rev Gastroenterol Hepatol. 2016;13:253–4.

    CAS  PubMed  Google Scholar 

  208. Moayyedi P, Eikelboom J, Bosch J, Dyal L, Connolly S, Yusuf S. Adverse events related to proton pump inhibitor therapy. Results of a randomized trial of pantoprazole versus placebo with 53,152 patient years of follow-up. Gastroenterology. 2019;156:S173–4.

    Google Scholar 

  209. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology. 2006;131:1392–9.

    PubMed  Google Scholar 

  210. Spechler SJ, Sharma P, Souza RF, et al. American Gastroenterological Association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–52.

    PubMed  Google Scholar 

  211. Wang KK, Sampliner RE, Practice Parameters Committee of the American College of Gastroenterology. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol. 2008;103:788–97.

    PubMed  Google Scholar 

  212. Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63:7–42.

    PubMed  Google Scholar 

  213. Lee YC, Cook MB, Bhatia S, et al. Interobserver reliability in the endoscopic diagnosis and grading of Barrett’s esophagus: an Asian multi-national study. Endoscopy. 2010;42:699–704.

    CAS  PubMed  PubMed Central  Google Scholar 

  214. Ishimura N, Amano Y, Sollano JD, et al. Questionnaire-based survey conducted in 2011 concerning endoscopic management of Barrett’s esophagus in East Asian countries. Digestion. 2012;86:136–46.

    PubMed  Google Scholar 

  215. Aida J, Vieth M, Ell C, et al. Palisade vessels as a new histologic marker of esophageal origin in ER specimens from columnar-lined esophagus. Am J Surg Pathol. 2011;35:1140–5.

    PubMed  Google Scholar 

  216. Kandiah K, Chedgy FJQ, Subramaniam S, et al. International development and validation of a classification system for the identification of Barrett’s neoplasia using acetic acid chromoendoscopy: the Portsmouth Acetic Acid Classification (PREDICT). Gut. 2018;67:2085–91.

    CAS  PubMed  Google Scholar 

  217. Sharma P, Bergman J, Goda K, et al. Development and validation of a classification system to identify high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus using narrow-band imaging. Gastroenterology. 2016;150:591–8.

    PubMed  Google Scholar 

  218. Smith RR, Hamilton SR, Boitnott JK, et al. The spectrum of carcinoma arising in Barrett’s esophagus. A clinicopathologic study of 26 patients. Am J Surg Pathol. 1984;8:563–73.

    CAS  PubMed  Google Scholar 

  219. Skinner DB, Walther BC, Riddell RH, et al. Barrett’s esophagus. Comparison of benign and malignant cases. Ann Surg. 1983;198:554–65.

    CAS  PubMed  PubMed Central  Google Scholar 

  220. Bhat S, Coleman HG, Yousef F, et al. Risk of malignant progression in Barrett’s esophagus patients: results from a large population-based study. J Natl Cancer Inst. 2011;103:1049–57.

    PubMed  PubMed Central  Google Scholar 

  221. Goda K, Singh R, Oda I, et al. Current status of endoscopic diagnosis and treatment of superficial Barrett’s adenocarcinoma in Asia-Pacific region. Dig Endosc. 2013;25 Suppl 2:146–50.

    PubMed  Google Scholar 

  222. Fock KM, Talley NJ, Fass R, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol. 2008;23:8–22.

    PubMed  Google Scholar 

  223. Harrison R, Perry I, Haddadin W, et al. Detection of intestinal metaplasia in Barrett’s esophagus: an observational comparator study suggests the need for a minimum of eight biopsies. Am J Gastroenterol. 2007;102:1154–61.

    PubMed  Google Scholar 

  224. Kelty CJ, Gough MD, Van Wyk Q, et al. Barrett’s oesophagus: intestinal metaplasia is not essential for cancer risk. Scand J Gastroenterol. 2007;42:1271–4.

    PubMed  Google Scholar 

  225. Gatenby PA, Ramus JR, Caygill CP, et al. Relevance of the detection of intestinal metaplasia in non-dysplastic columnar-lined oesophagus. Scand J Gastroenterol. 2008;43:524–30.

    PubMed  Google Scholar 

  226. Montgomery E, Bronner MP, Goldblum JR, et al. Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol. 2001;32:368–78.

    CAS  PubMed  Google Scholar 

  227. Kerkhof M, van Dekken H, Steyerberg EW, et al. Grading of dysplasia in Barrett’s oesophagus: substantial interobserver variation between general and gastrointestinal pathologists. Histopathology. 2007;50:920–7.

    CAS  PubMed  Google Scholar 

  228. Curvers WL, ten Kate FJ, Krishnadath KK, et al. Low-grade dysplasia in Barrett’s esophagus: overdiagnosed and underestimated. Am J Gastroenterol. 2010;105:1523–30.

    PubMed  Google Scholar 

  229. Duits LC, Phoa KN, Curvers WL, et al. Barrett’s oesophagus patients with low-grade dysplasia can be accurately risk-stratified after histological review by an expert pathology panel. Gut. 2015;64:700–6.

    PubMed  Google Scholar 

  230. Alikhan M, Rex D, Khan A, et al. Variable pathologic interpretation of columnar lined esophagus by general pathologists in community practice. Gastrointest Endosc. 1999;50:23–6.

    CAS  PubMed  Google Scholar 

  231. Quante M, Graham TA, Jansen M. Insights into the pathophysiology of esophageal adenocarcinoma. Gastroenterology. 2018;154:406–20.

    CAS  PubMed  Google Scholar 

  232. Epari K, Cade R. Oesophagectomy for tumours and dysplasia of the oesophagus and gastro-oesophageal junction. ANZ J Surg. 2009;79:251–7.

    PubMed  Google Scholar 

  233. Qiao Y, Hyder A, Bae SJ, et al. Surveillance in patients with Barrett’s esophagus for early detection of esophageal adenocarcinoma: a systematic review and meta-analysis. Clin Transl Gastroenterol. 2015;6:e131.

    PubMed  PubMed Central  Google Scholar 

  234. Cherian JV, Sivaraman R, Muthusamy AK, Jayanthi V. Carcinoma of the esophagus in Tamil Nadu (South India): 16-year trends from a tertiary center. J Gastrointestin Liver Dis. 2007;16:245–9.

    PubMed  Google Scholar 

  235. Streitz JM Jr, Andrews CW Jr, Ellis FH Jr. Endoscopic surveillance of Barrett’s esophagus. Does it help? J Thorac Cardiovasc Surg. 1993;105:383–7.

    PubMed  Google Scholar 

  236. Peters JH, Clark GW, Ireland AP, et al. Outcome of adenocarcinoma arising in Barrett’s esophagus in endoscopically surveyed and nonsurveyed patients. J Thorac Cardiovasc Surg. 1994;108:813–21.

    CAS  PubMed  Google Scholar 

  237. van Sandick JW, van Lanschot JJ, Kuiken BW, et al. Impact of endoscopic biopsy surveillance of Barrett’s oesophagus on pathological stage and clinical outcome of Barrett’s carcinoma. Gut. 1998;43:216–22.

    PubMed  PubMed Central  Google Scholar 

  238. Corley DA, Levin TR, Habel LA, et al. Surveillance and survival in Barrett’s adenocarcinomas: a population-based study. Gastroenterology. 2002;122:633–40.

    PubMed  Google Scholar 

  239. Cooper GS, Yuan Z, Chak A, et al. Association of pre-diagnosis endoscopy with stage and survival in adenocarcinoma of the esophagus and gastric cardia. Cancer. 2002;95:32–8.

    PubMed  Google Scholar 

  240. Fountoulakis A, Zafirellis KD, Dolan K, et al. Effect of surveillance of Barrett’s oesophagus on the clinical outcome of oesophageal cancer. Br J Surg. 2004;91:997–1003.

    CAS  PubMed  Google Scholar 

  241. Rubenstein JH, Sonnenberg A, Davis J, et al. Effect of a prior endoscopy on outcomes of esophageal adenocarcinoma among United States veterans. Gastrointest Endosc. 2008;68:849–55.

    PubMed  PubMed Central  Google Scholar 

  242. Corley DA, Mehtani K, Quesenberry C, et al. Impact of endoscopic surveillance on mortality from Barrett’s esophagus-associated esophageal adenocarcinomas. Gastroenterology. 2013;145:312–9.

    PubMed  Google Scholar 

  243. Gordon LG, Mayne GC, Hirst NG, et al. Cost-effectiveness of endoscopic surveillance of non-dysplastic Barrett’s esophagus. Gastrointest Endosc. 2014;79:242–56.

    PubMed  Google Scholar 

  244. Visrodia K, Iyer PG, Schleck CD, Zinsmeister AR, Katzka DA. Yield of repeat endoscopy in Barrett’s esophagus with no dysplasia and low-grade dysplasia: a population-based study. Dig Dis Sci. 2016;61:158–67.

    CAS  PubMed  Google Scholar 

  245. Rodriguez S, Mattek N, Lieberman D, Fennerty B, Eisen G. Barrett’s esophagus on repeat endoscopy: should we look more than once? Am J Gastroenterol. 2008;103:1892–7.

    PubMed  PubMed Central  Google Scholar 

  246. Hanna S, Rastogi A, Weston AP, et al. Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis. Am J Gastroenterol. 2006;101:1416–20.

    PubMed  Google Scholar 

  247. Castell DO, Kahrilas PJ, Richter JE, et al. Esomeprazole (40 mg) compared with lansoprazole (30 mg) in the treatment of erosive esophagitis. Am J Gastroenterol. 2002;97:575–83.

    CAS  PubMed  Google Scholar 

  248. Richter JE, Kahrilas PJ, Sontag SJ, Kovacs TO, Huang B, Pencyla JL. Comparing lansoprazole and omeprazole in onset of heartburn relief: results of a randomized, controlled trial in erosive esophagitis patients. Am J Gastroenterol. 2001;96:3089–98.

    CAS  PubMed  Google Scholar 

  249. Palmer ED. The hiatus herniaesophagitis-esophageal stricture complex: twenty-year prospective study. Am J Med. 1968;44:566–79.

    CAS  PubMed  Google Scholar 

  250. Rejeb BM, Bouche O, Zeitoun P. Study of 47 consecutive patients with peptic esophageal stricture compared with 3880 cases of reflux esophagitis. Dig Dis Sci. 1992;37:733–6.

    PubMed  Google Scholar 

  251. Marks RD, Richter JE, Rizzo J, et al. Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis. Gastroenterology. 1994;106:907–15.

    CAS  PubMed  Google Scholar 

  252. Fass R, Cahn F, Scotti DJ, Gregory DA. Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease. Surg Endos. 2017;31:4865–82.

    PubMed  Google Scholar 

  253. Kalapala R, Shah H, Nabi Z, Darisetty S, Talukdar R, Nageshwar Reddy D. Treatment of gastroesophageal reflux disease using radiofrequency ablation (Stretta procedure): an interim analysis of a randomized trial. Indian J Gastroenterol. 2017;36:337–42.

    PubMed  Google Scholar 

  254. Koch OO, Kaindlstorfer A, Antoniou SA, Spaun G, Pointner R, Swanstrom LL. Subjective and objective data on esophageal manometry and impedance pH monitoring 1 year after endoscopic full-thickness plication for the treatment of GERD by using multiple plication implants. Gastrointest Endosc. 2013;77:7–14.

    PubMed  Google Scholar 

  255. Zaninotto G, Attwood SE. Surgical management of refractory gastro-oesophageal reflux. Br J Surg. 2010;97:139–40.

    CAS  PubMed  Google Scholar 

  256. Jiang Y, Cui W-X, Wang Y, et al. Antireflux surgery vs medical treatment for gastroesophageal reflux disease: a meta-analysis. World J Meta-Anal. 2015;3:284–94.

    Google Scholar 

  257. The SAGES Guidelines Committee, Stefanidis D, Hope WW, Kohn GP, Reardon PR, Richardson WS, et al. Guidelines for surgical treatment of gastroesophageal reflux disease. Surg Endosc. 2010;24:2647–69.

    Google Scholar 

  258. Peters MJ, Mukhtar A, Yunus RM, et al. Meta-analysis of randomized clinical trials comparing open and laparoscopic anti-reflux surgery. Am J Gastroenterol. 2009;104:1548–61.

    PubMed  Google Scholar 

  259. Singhal V, Khaitan L. Preoperative evaluation of gastroesophageal reflux disease. Surg Clin North Am. 2015;95:615–27.

    PubMed  Google Scholar 

  260. Nagpal AP, Soni H, Haribhakti S. Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry. J Minim Access Surg. 2010;6:66–9.

    PubMed  PubMed Central  Google Scholar 

  261. Nagpal AP, Soni H, Haribhakti SP. Retrospective evaluation of patients of gastroesophageal reflux disease treated with laparoscopic Nissen’s fundoplication. J Minim Access Surg. 2010;6:42–5.

    PubMed  PubMed Central  Google Scholar 

  262. Herregods TV, Troelstra M, Weijenborg PW, et al. Patients with refractory reflux symptoms often do not have GERD. Neurogastroenterol Motil. 2015;27:1267–73.

    CAS  PubMed  Google Scholar 

  263. Khajanchee YS, Dunst CM, Swanstrom LL. Outcomes of Nissen fundoplication in patients with gastroesophageal reflux disease and delayed gastric emptying. Arch Surg. 2009;144:823–8.

    PubMed  Google Scholar 

  264. Noar MD, Noar E. Gastroparesis associated with gastroesophageal reflux disease and corresponding reflux symptoms may be corrected by radiofrequency ablation of the cardia and esophagogastric junction. Surg Endosc. 2008;22:2440–4.

    PubMed  Google Scholar 

Download references

Funding

The members of the ISG Task Force thank Emcure Pharmaceuticals for providing an unrestricted grant to conduct the face-to-face consensus meeting.

Author information

Authors and Affiliations

  1. Seth GS Medical College and KEM Hospital, Mumbai, 400 012, India

    Shobna J. Bhatia & Abhinav Jain

  2. All India Institute of Medical Sciences, New Delhi, 110 029, India

    Govind K. Makharia, Vineet Ahuja & Saurabh Kedia

  3. P D Hinduja Hospital and MRC, and Hinduja Heathcare Surgical, Mumbai, 400 016, India

    Philip Abraham

  4. Aster CMI Hospital, Bengaluru, 560 092, India

    Naresh Bhat

  5. Fortis Escorts Liver and Digestive Diseases Institute, Delhi, 110 025, India

    Ajay Kumar

  6. Asian Institute of Gastroenterology, Hyderabad, 500 082, India

    D. Nageshwar Reddy, G. Venkat Rao, Rohit Dama & Rakesh Kalapala

  7. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India

    Uday C. Ghoshal

  8. Government Medical College, Trivandrum, 695 011, India

    Krishnadas Devadas

  9. Christian Medical College, Vellore, 632 004, India

    Amit K. Dutta

  10. Victor Hospital, Margao, Goa, 403 601, India

    Jose Filipe Alvares

  11. S N Medical College, Jodhpur, 342 003, India

    Sunil Dadhich

  12. Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India

    Vinod Kumar Dixit

  13. Appollo Gleneagles Hospitals, Kolkata, 700 054, India

    Mahesh Kumar Goenka

  14. Gauhati Medical College, Dispur Hospitals, Guwahati, 781 032, India

    B. D. Goswami

  15. JLN Hospital and Research Center, Bhilai Steel Plant, Bhilai, 490 009, India

    Sanjeev K. Issar

  16. PSG Institute of Medical Sciences, Coimbatore, 641 002, India

    Venkatakrishnan Leelakrishnan

  17. Tata Medical Center, Kolkata, 700 156, India

    Mohandas K. Mallath

  18. PVS Memorial Hospital, Kochi, 682 017, India

    Philip Mathew

  19. Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, 560 066, India

    Praveen Mathew

  20. Surat Institute of Digestive Sciences, Surat, 395 002, India

    Subhashchandra Nandwani

  21. Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576 104, India

    Cannanore Ganesh Pai

  22. Columbia Asia Hospital, Bengaluru, 560 075, India

    Lorance Peter

  23. Institute of Gastroenterology, Visakhapatnam, 530 002, India

    A. V. Siva Prasad

  24. Apollo Hospitals, Bilaspur, 495 006, India

    Devinder Singh

  25. Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, 190 001, India

    Jaswinder Singh Sodhi

  26. Medanta - The Medicity, Gurugram, 122 001, India

    Randhir Sud

  27. Gleneagles Global Health City, Chennai, 600 100, India

    Jayanthi Venkataraman

  28. Dayanand Medical College and Hospital, Ludhiana, 141 001, India

    Vandana Midha & Ajit Sood

  29. Deenanath Mangeshkar Hospital and Research Center, Pune, 411 004, India

    Amol Bapaye

  30. Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Usha Dutta & Rakesh Kochhar

  31. Choithram Hospital and Research Centre, Indore, 452 014, India

    Ajay K. Jain

  32. GB Pant Hospital, Delhi, 110 002, India

    Amarender S. Puri

  33. S C B Medical College, Manglabag, Cuttack, 753 007, India

    Shivram Prasad Singh

  34. Jehangir Hospital, Pune, 411 001, India

    Lalit Shimpi

  35. Apollo BGS Hospitals, Mysuru, 570 023, India

    Rajkumar T. Wadhwa

Authors
  1. Shobna J. Bhatia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Govind K. Makharia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philip Abraham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naresh Bhat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ajay Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Nageshwar Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Uday C. Ghoshal
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vineet Ahuja
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. G. Venkat Rao
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Krishnadas Devadas
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Amit K. Dutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Abhinav Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Saurabh Kedia
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Rohit Dama
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Rakesh Kalapala
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Jose Filipe Alvares
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Sunil Dadhich
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Vinod Kumar Dixit
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Mahesh Kumar Goenka
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. B. D. Goswami
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Sanjeev K. Issar
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Venkatakrishnan Leelakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Mohandas K. Mallath
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Philip Mathew
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Praveen Mathew
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Subhashchandra Nandwani
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Cannanore Ganesh Pai
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Lorance Peter
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. A. V. Siva Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Devinder Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Jaswinder Singh Sodhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Randhir Sud
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Jayanthi Venkataraman
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Vandana Midha
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Amol Bapaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Usha Dutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Ajay K. Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Rakesh Kochhar
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Amarender S. Puri
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Shivram Prasad Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  41. Lalit Shimpi
    View author publications

    You can also search for this author in PubMed Google Scholar

  42. Ajit Sood
    View author publications

    You can also search for this author in PubMed Google Scholar

  43. Rajkumar T. Wadhwa
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AKD, SJB, UCG, VA, KD, and GVR generated the initial list of statements. AJ coordinated with the responders for the second round of voting. AKD, AJ, UCG, SK, KD, RD, and RK presented the evidence in seven parts at the final face-to-face meeting. Other members of the ISG Task Force voted in all the three rounds. All authors approved the manuscript.

Corresponding author

Correspondence to Shobna J. Bhatia.

Ethics declarations

Conflict of interest

SJB, GKM, PA, NB, AK, DNR, UCG, VA, GVR, KD, AKD, AJ, SK, RD, RK, JFA, SD, VKD, MKG, BDG, SKI, VL, MKM, PM, PM, SN, CGP, LP, AVSP, DS, JSS, RS, JV, VM, AB, UD, AKJ, RK, ASP, SPS, LS, AS, and RTW declare that they have no conflict of interest.

Ethical statement

The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Disclaimer

The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bhatia, S.J., Makharia, G.K., Abraham, P. et al. Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology. Indian J Gastroenterol 38, 411–440 (2019). https://doi.org/10.1007/s12664-019-00979-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-019-00979-y

Keywords

Search

Navigation