Primer Consenso Venezolano de Enfermedad por Reflujo Gastroesofágico

• Published in: Archivos venezolanos de farmacología y terapéutica 2011-01, Vol.30 (1), p.1
• Main Authors: González, J C, Louis, C E, Piñero, R E, Rangel, R, Aldana, L, Angelosante, S, Aponte, R, Aure, C, Bandres, D, Bethelmy, A, Bronstein, M, Castillo, J, Castro, D, Dib, J, Dolfo, W, Fernandez, S, Folkmanas, W, Fonseca, A, Galvis, E, Garcia, J G, Gumina, C, Guzmán, A, Latuff, Z, Lindado, C E, López, O, Mago, V, Marichal, J, Marín, B, Mora, N, Parra, C, Parra, L, Ruiz, M E, Saavedra, M, Salas, Z, Salazar, P, Silva, O, Sosa, L, Tenia, J C, Useche, E, Urbina, B, Urquiola, G, Uzcategui, A, Valenciano, M, Velasco, V, Yasin, G, Rojas, G, Sánchez, N, Soles, R, Castellano, C, Medina, G, Sacca, F, Santamaría, L, Betancourt, Ch, Cova, J, Tepedino, D, Pérez, H, Dos Reis, V
• Format: Article
• Language: Spanish
• Subjects: Gastroesophageal reflux; Inhibitor drugs; Laser surgery; Medical diagnosis
• ISSN: 0798-0264; 2610-7988

The Venezuelan Gastroesophageal Reflux Disease (GERD) Consensus was carried out in order to provide guidelines to improve the identification, diagnosis and treatment of this illness in Venezuela. The coordinators established the consensus lines, based on a systematic revision of the medical literature of the last 15 years starting from 1995. 55 physicians participated with the support of their respective medical schools and local societies. They revised and presented the topics with their respective evidence levels and recommendation grades to discuss and vote them in a plenary meeting. After a final report of the members, the coordinators prepared the definitive declarations. The consensus concluded that GERD prevalence in Venezuela is 11,54%, higher in women than men (Grade B). The diagnosis is mainly clinical, based on the presence of typical and/or atypical symptoms and alarm symptoms that may suggest the presence of complications (Grade B). Endoscopy is important when reflux esophagitis and laryngitis are present (Grade B). Other diagnostic tests as ambulatory 24 hours pH monitoring with or without multichannel intraluminal impedance are important in patients without esophagitis, with atypical symptoms or when there is flaw in the answer to the medical treatment (Grade B). Radiology, esophageal manometry and endoscopic ultrasonography are not indicated in the diagnosis of GERD (Grade B). The objective of the treatment is to reduce the presence of acid in the esophagus and consequently: alleviate the symptoms and heal lesions in the esophagus mucosa to prevent recurrence and complications. Proton pump inhibitors should be the first option drug in the treatment of GERD syndrome and in esophagitis during the acute and the maintenance phase using standard or half dose (Grade A). So far, pokinetics are drugs with a limited use in GERD patients; they stimulate the esophagus/gastric motility, increase the tone of the lower esophagic sphincter and accelerate gastric emptying (Grade B). Surgical treatment is indicated in selected patients where laparoscopy and the partial fundoplication have less complications (Grade B). Endoscopic treatment is controversial and is not recommended by this consensus until new techniques arise or the existent ones are perfected. (Grade B). [PUBLICATION ABSTRACT]