Korean J Gastroenterol.  2011 Feb;57(2):57-66. 10.4166/kjg.2011.57.2.57.

Guidelines for the Treatment of Gastroesophageal Reflux Disease

Affiliations
  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan Univsersity School of Medicine, Seoul, Korea.
  • 2Department of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
  • 4Department of Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 6Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea. joonlee@schmc.ac.kr
  • 7Department of Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

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.

Keyword

Gastroesophageal reflux disease; Treatment; Guideline

MeSH Terms

Antacids/therapeutic use
Antidepressive Agents/therapeutic use
Drug Therapy, Combination
Gastroesophageal Reflux/surgery/*therapy
Histamine Antagonists/therapeutic use
Humans
Muscle Relaxants, Central/therapeutic use
Proton Pump Inhibitors/therapeutic use

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