tailieunhanh - UPDATED GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

An unusually large number of people sickened by a disease in a certain place and time is known as a ‘disease cluster’. Clusters of cancer, birth defects, and other chronic illnesses have sometimes been linked to chemicals or other toxic pollutants in local communities, although these links can be controversial. There is a need for better documentation and investigation of disease clusters to identify and address possible causes. Meanwhile, toxic chemicals should be identified and controlled through reform of the Toxic Substances Control Act, so these chemicals don’t pollute communities and sicken people. . | American Journal of Gastroenterology 2005 by Am. Coll. of Gastroenterology Published by Blackwell Publishing ISSN 0002-9270 doi PRACTICE GUIDELINES Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease Kenneth R. DeVault . . and Donald O. Castell . . Departments of Medicine Mayo Clinic College of Medicine Jacksonville Florida and Medical University of South Carolina Charleston South Carolina 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. Am J Gastroenterol 2005 100 190-200 INTRODUCTION AND PREAMBLE Guidelines for the diagnosis and treatment of gastroesophageal reflux disease GERD were published by the American College of Gastroenterology in 1995 and updated in 1999 1 2 . These and other guidelines undergo periodic review. Advances continue to be made in the area of GERD leading us to review and revise our previous guidelines statements. These and the original guidelines are intended to apply to all health-care .