TY - JOUR
T1 - Brazilian consensus on gastroesophageal reflux disease
T2 - Proposals for assessment, classification, and management
AU - Moraes-Filho, Joaquim Prado P.
AU - Cecconello, Ivan
AU - Gama-Rodrigues, Joaquim
AU - De Paula Castro, Luiz
AU - Henry, Maria Aparecida
AU - Meneghelli, Ulisses G.
AU - Quigley, Eamonn
N1 - Funding Information:
None of these have, however, specifically addressed GERD in a Latin-American context. Mindful of the possible influence of differing demographic, socioeconomic, and disease factors on the management of GERD in this part of the world, 50 Brazilian specialists, invited by the Department of Gastroenterology, Faculty of Medicine at the University of São Paulo, met in São Paulo to debate and propose a management strategy for GERD in Brazil. The event was supported by the Brazilian Federation of Gastroenterology, the Brazilian Society of Digestive Motility, the Brazilian Society of Digestive Endoscopy, and the Brazilian College of Digestive Surgery. This article represents the conclusions of this consensus meeting. Consensus conclusions and recommendations are presented in italics, and commentary in roman type.
Funding Information:
Support for the Brazilian Consensus was provided by unrestricted educational grants from the following pharmaceutical companies: Abbott, AstraZeneca, Byk Gulden, and Janssen-Cilag.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation "short Barrett's" is not important in terms of management and prognosis.
AB - The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation "short Barrett's" is not important in terms of management and prognosis.
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U2 - 10.1016/S0002-9270(01)04038-2
DO - 10.1016/S0002-9270(01)04038-2
M3 - Article
C2 - 11866257
AN - SCOPUS:0036180921
SN - 0002-9270
VL - 97
SP - 241
EP - 248
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 2
ER -