The American College of Gastroenterology released new treatment guidelines on the diagnosis and management of gastroesophageal reflux disease (GERD) in the March issue of The American Journal of Gastroenterology.
The new guidelines review the presentations of risk factors for GERD and provide recommendations for medical, surgical, and endoscopic management, including efficacy comparisons of different treatments. In addition, they also address extraesophageal symptoms including asthma, chronic cough and laryngitis, and complications such as erosive esophagitis, peptic stricture, Barrett’s esophagus, as well as the evaluation and management of refractory GERD symptoms.
Recommendations on potential risks associated with proton pump inhibitors (PPIs) are included in the new guidelines. These include:
- Switching PPIs can be considered in the setting of side-effects.
- Patients with known osteoporosis can remain on PPI therapy. Concern for hip fractures and osteoporosis should not affect the decision to use PPI long-term except in patients with other risk factors for hip fracture.
- PPI therapy can be a risk factor for Clostridium difficile infection, and should be used with care in patients at risk.
- Short-term PPI usage may increase the risk of community-acquired pneumonia. The risk does not appear elevated in long-term users.
- PPI therapy does not need to be altered in concomitant clopidogrel users as there does not appear to be an increased risk for adverse cardiovascular events.
For more information call (301) 263-9000 or view the full guideline here.