Abstract
In Japan, with the increasing prevalence of gastroesophageal reflux disease (GERD) and growing public interest, the Japanese Society of Gastroenterology issued Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009 and a revised 2nd edition in 2015. A number of studies on GERD were subsequently conducted in Japan and abroad, and vonoprazan, a potassium-competitive acid blocker (P-CAB), became available for the first time in Japan in February 2015. The revised 3rd edition (Japanese edition), which incorporates new findings and information, was published in April 2021. These guidelines are summarized herein, particularly sections related to the treatment of GERD. The important clinical issues addressed in the present revision are (i) the introduction of treatment algorithms that classify GERD into reflux esophagitis and non-erosive reflux disease, (ii) the clarification of treatment algorithms based on to the severity of reflux esophagitis, and (iii) the positioning of vonoprazan in the treatment for GERD. The present guidelines propose vonoprazan as the initial/maintenance treatment for severe reflux esophagitis. They also recommend vonoprazan or PPI as an initial treatment for mild reflux esophagitis and recommended PPI and proposed vonoprazan as maintenance treatment. These updated guidelines offer the best clinical strategies for GERD patients in Japan and hope that they will be of global use for the diagnosis and treatment for GERD.
Highlights
Evidence-based clinical practice guidelines for gastroesophageal reflux disease (GERD) 2015 were published in October 2015 [1]
The prevalence of GERD has been increasing since the end of the 1990s due to the enhanced secretion of gastric acid, a decrease in the Helicobacter pylori infection rate, and a westernized lifestyle [7]
In the Rome IV criteria revised in 2016, diseases presenting with heartburn, such as GERD, were classified into four categories: erosive esophagitis, non-erosive reflux disease (NERD), reflux hypersensitivity, and functional heartburn, based on esophageal hypersensitivity and acid exposure [36]
Summary
Evidence-based clinical practice guidelines for gastroesophageal reflux disease (GERD) 2015 (revised 2nd edition) were published in October 2015 [1]. After the final draft of the guidelines was evaluated by the guideline evaluation committee and modified, it was disclosed to the JSGE members, public comments were made, and, through discussions on public comments, the present guidelines were completed This manuscript is an English version that mainly focuses on the treatment section of Evidence-based clinical practice guidelines for GERD 2021. It consists of a brief summary of each section of the guidelines, ‘‘recommendations’’ and ‘‘comments’’ on CQs related to diagnosis and treatment, and ‘‘statements’’ and ‘‘comments’’ concerning FRQs. By presenting the algorithms for the diagnosis and treatment of GERD, it aims to disseminate these guidelines worldwide.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
