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Lookup NU author(s): Emeritus Professor Amritpal Hungin
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. Patients with reflux-like symptoms (heartburn and regurgitation) are often not well advised on implementing individualised strategies to help control their symptoms using dietary changes, lifestyle modifications, behavioural changes or fast-acting rescue therapies. One reason for this may be the lack of emphasis in management guidelines owing to 'low-quality' evidence and a paucity of interventional studies. Thus, a panel of 11 gastroenterologists and primary care doctors used the Delphi method to develop consolidated advice for patients based on expert consensus. A steering committee selected topics for literature searches using the PubMed database, and a modified Delphi process including two online meetings and two rounds of voting was conducted to generate consensus statements based on prespecified criteria (67% voting 'strongly agree' or 'agree with minor reservation'). After expert discussion and two rounds of voting, 21 consensus statements were generated, and assigned strength of evidence and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) rating. Eleven statements achieved the strongest (100%) agreement: five are related to diet and include identification and avoidance of dietary triggers, limiting alcohol, coffee and carbonated beverages, and advising patients troubled by postprandial symptoms not to overeat; the remaining six statements concern advice around smoking cessation, weight loss, raising the head-of-the-bed, avoiding recumbency after meals, stress reduction and alginate use. The aim of developing the consensus statements is that they may serve as a foundation for tools and advice that can routinely help patients with reflux-like symptoms better understand the causes of their symptoms and manage their individual risk factors and triggers.
Author(s): Hungin AP, Yadlapati R, Anastasiou F, Bredenoord AJ, El Serag H, Fracasso P, Mendive JM, Savarino EV, Sifrim D, Udrescu M, Kahrilas PJ
Publication type: Article
Publication status: Published
Journal: European Journal of Gastroenterology & Hepatology
Year: 2024
Volume: 36
Issue: 1
Pages: 13-25
Print publication date: 01/01/2024
Acceptance date: 11/10/2023
Date deposited: 18/12/2023
ISSN (print): 0954-691X
ISSN (electronic): 1473-5687
Publisher: Lippincott Williams & Wilkins
URL: https://doi.org/10.1097/MEG.0000000000002682
DOI: 10.1097/MEG.0000000000002682
PubMed id: 38006602
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