Guidelines for the Treatment of Gastroesophageal Reflux Disease

Jun Haeng Lee; Yu Kyung Cho; Seong Woo Jeon; Jie Hyun Kim; Nayoung Kim; Joon Seong Lee; Young-Tae Bak; The Korean Society of Neurogastroenterology and Motility

doi:10.4166/kjg.2011.57.2.57

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Lee, Cho, Jeon, Kim, Kim, Lee, Bak, and Motility: Guidelines for the Treatment of Gastroesophageal Reflux Disease

Special Review

Korean J Gastroenterol 2011;57(2):57-66.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.2.57

Guidelines for the Treatment of Gastroesophageal Reflux Disease

Jun Haeng Lee, Yu Kyung Cho¹, Seong Woo Jeon², Jie Hyun Kim³, Nayoung Kim⁴, Joon Seong Lee⁵, Young-Tae Bak⁶, The Korean Society of Neurogastroenterology and Motility

Department of Medicine, Samsung Medical Center, Sungkyunkwan Univsersity School of Medicine, Seoul, Korea

¹The Catholic University of Korea, Seoul, Korea

²Kyungpook National University School of Medicine, Daegu, Korea

³Yonsei University College of Medicine, Seoul, Korea

⁴Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

⁵Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea

⁶Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence to: Joon Seong Lee, Institute for Digestive Research, Soonchunhyang University College of Medicine, Daesagwan-gil 22, Yongsan-gu, Seoul 140-743, Korea. Tel: +82-2-709-9202, Fax: +82-2-709-9696, E-mail: joonlee@schmc.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastroesophageal reflux disease (GERD) is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. In the last decade, GERD has been increasing in Korea. Seventeen consensus statements for the treatment of GERD were developed using the modified Delphi approach. Acid suppression treatments, such as proton pump inhibitors (PPIs), histmine-2 receptor antagonists and antacids are effective in the control of GERD-related symptoms. Among them, PPIs are the most effective medication. Standard dose PPI is recommended as the initial treatment of erosive esophagitis (for 8 weeks) and non-erosive reflux disease (at least for 4 weeks). Long-term continuous PPI or on-demand therapy is required for the majority of GERD patients after the initial treatment. Anti-reflux surgery can be considered in well selected patients. Prokinetic agents and mucosal protective drugs have limited roles. Twice daily PPI therapy can be tried to control extra-esophageal symptoms of GERD. For symptomatic patients with Barrett's esophagus, long-term treatment with PPI is required. Further studies are strongly needed to develop better treatment strategies for Korean patients with GERD.

Keywords: Gastroesophageal reflux disease, Treatment, Guideline

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