Open AccessRomanian Guidelines for the Diagnosis and Treatment of GERD-induced Respiratory Manifestations
Author(s) -
Vasile Drug,
Sabina A Antoniu,
Barboi Bogdana Oana,
Oana Cristina Arghir,
Ion Băncilă,
Simona Băţagă,
Ciprian Brisc,
Cristina Cijevschi-Prelipcean,
Mihai Ciocîrlan,
Irina Ciortescu,
Liliana David,
Oana Deleanu,
Mircea Diculescu,
Anca Dimitriu,
Daniela Dobru,
Eugen Dumitru,
Dan Ionuţ Gheonea,
Cristian Gheorghe,
Adrian Goldiș,
Mariana Jinga,
Milena Adina Man,
Bogdan Mateescu,
Mircea Mănuc,
Cătălina Mihai,
Florin Mihălţan,
T Mihăescu,
Laurențiu Nedelcu,
Lucian Negreanu,
Carmen Monica Pop,
Ruxandra Râjnoveanu,
Adrian Săftoiu,
Andrada Seicean,
Ioan Sporea,
C Stanciu,
Teodora Surdea-Blaga,
Marcel Tanțău,
Doina Adina Todea,
Anca Trifan,
Ruxandra Ulmeanu,
Diana Elena Iov,
Dan L. Dumitrașcu
Publication year - 2022
Publication title -
journal of gastrointestinal and liver diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 48
eISSN - 1842-1121
pISSN - 1841-8724
DOI - 10.15403/jgld-4196
Subject(s) - medicine , gerd , romanian , intensive care medicine , respiratory system , medline , disease , reflux , linguistics , philosophy , political science , law
Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in daily practice with a wide range of clinical phenotypes. In this line, respiratory conditions may be associated with GERD. The Romanian Societies of Gastroenterology and Neurogastroenterology, in association with the Romanian Society of Pneumology, aimed to create a guideline regarding the epidemiology, diagnosis and treatment of respiratory conditions associated with GERD.Methods: Delphi methodology was used and eleven common working groups of experts were created. The experts reviewed the literature according to GRADE criteria and formulated 34 statements and recommendations. Consensus (>80% agreement) was reached for some of the statements after all participants voted.Results: All the statements and the literature review are presented in the paper, together with their correspondent grade of evidence and the voting results. Based on >80% voting agreement, a number of 22 recommendations were postulated regarding the diagnosis and treatment of GERD-induced respiratory symptoms. The experts considered that GERD may cause bronchial asthma and chronic cough in an important number of patients through micro-aspiration and vagal-mediated tracheobronchial reflex. GERD should be suspected in patients with asthma with suboptimal controlled or after exclusion of other causes, also in nocturnal refractory cough which needs gastroenterological investigations to confirm the diagnosis. Therapeutic test with double dose proton pump inhibitors (PPI) for 3 months is also useful. GERD induced respiratory conditions are difficult to treat; however,proton pump inhibitors and laparoscopic Nissen fundoplication are endorsed for therapy.Conclusions: This guideline could be useful for the multidisciplinary management of GERD with respiratory symptoms in current practice.