| Citation: |
WANG Jiali, LI Xiaohong, PEI Wenjing, LI Junxiang. Interpretation of Updates to the Modern Diagnosis of GERD: Lyon Consensus 2.0[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(1): 125-132. DOI: 10.12290/xhyxzz.2024-0681
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Updates to the modern diagnosis of GERD: Lyon consensus 2.0 was published online in September 2023. It presents 23 consensus statements that update the modern definition of gastro-esophageal reflux disease (GERD) and optimize the diagnosis and management of GERD, providing an up-to-date basis for the diagnosis and treatment of GERD. The international consensus is based on the evaluation of studies conducted since the original consensus was published. However, due to the limitations of evidence-based evidence and the differences in national conditions, populations, and economic levels of different countries, it is necessary to interpret its applicability in China, so as to better promote the dissemination of its content and its implementation, and provide patients with the most appropriate guidance for clinical practice.
| [1] |
Fass R, Boeckxstaens G E, El-Serag H, et al. Gastro-oesophageal reflux disease[J]. Nat Rev Dis Primers, 2021, 7(1): 55. DOI: 10.1038/s41572-021-00287-w
|
| [2] |
中国中西医结合学会消化系统疾病专业委员会. 胃食管反流病中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(3): 221-226, 232.
Digestive System Disease Professional Committee of the Chinese Society of Integrated Traditional Chinese and Western Medicine. Consensus opinion on integrated traditional Chinese and western medicine diagnosis and treatment of gastroesophageal reflux disease (2017)[J]. Chin J Integr Trad West Med Dig, 2018, 26(3): 221-226, 232.
|
| [3] |
中华医学会消化病学分会. 2020年中国胃食管反流病专家共识[J]. 中华消化杂志, 2020, 40(10): 649-663. DOI: 10.3760/cma.j.cn311367-20200918-00558
Chinese Society of Gastroenterology, Chinese Medical Association. Chinese expert consensus of gastroesophageal reflux disease in 2020[J]. Chin J Dig, 2020, 40(10): 649-663. DOI: 10.3760/cma.j.cn311367-20200918-00558
|
| [4] |
中国医疗保健国际交流促进会胃食管反流病学分会. 中国胃食管反流病多学科诊疗共识2022(一)[J]. 中华胃食管反流病电子杂志, 2022, 9(2): 51-86.
Society of Gastroesophageal Reflux Disease, China International Exchange and Promotive Association for Medical and Health Care. Chinese consensus on multidisciplinary diagnosis and treatment of gastroesophageal reflux disease 2022 (1)[J]. Chin J Gastroesophageal Reflux Dis (Electron Ed), 2022, 9(2): 51-86.
|
| [5] |
中华医学会消化病学分会胃肠动力学组, 大中华区消化动力联盟. 食管动态反流监测临床操作指南(成人)[J]. 中华消化杂志, 2021, 41(3): 149-158. DOI: 10.3760/cma.j.cn311367-20210114-00032
Gastrointestinal Motility Group, Chinese Society of Gastroenterology, Chinese Medical Association, Greater China Gastrointestinal Motility Expert Alliance. Clinical guideline for esophageal ambulatory reflux monitoring in adults[J]. Chin J Dig, 2021, 41(3): 149-158. DOI: 10.3760/cma.j.cn311367-20210114-00032
|
| [6] |
中华医学会消化病学分会胃肠动力学组, 胃肠功能性疾病协作组, 食管疾病协作组. 中国胃食管反流病诊疗规范[J]. 中华消化杂志, 2023, 43(9): 588-598. DOI: 10.3760/cma.j.cn311367-20230626-00289
Chinese Society of Gastroenterology, Chinese Medical Association, Gastrointestinal Motility Group, Chinese Society of Gastroenterology, Chinese Medical Association, Functional Gastrointestinal Disease Group, Chinese Society of Gastroenterology, Chinese Medical Association, Esophageal Disease Group. Chinese guideline for diagnosis and treatment of gastroesophageal reflux disease[J]. Chin J Dig, 2023, 43(9): 588-598. DOI: 10.3760/cma.j.cn311367-20230626-00289
|
| [7] |
中华中医药学会脾胃病分会. 胃食管反流病中医诊疗专家共识(2023)[J]. 中医杂志, 2023, 64(18): 1935-1944.
Spleen and Stomach Diseases Branch of Chinese Association of Chinese Medicine. Expert consensus on the diagnosis and treatment of gastroesophageal reflux disease with traditional Chinese medicine(2023)[J]. J Tradit Chin Med, 2023, 64(18): 1935-1944.
|
| [8] |
Gyawali C P, Kahrilas P J, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus[J]. Gut, 2018, 67(7): 1351-1362. DOI: 10.1136/gutjnl-2017-314722
|
| [9] |
Gyawali C P, Yadlapati R, Fass R, et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0[J]. Gut, 2024, 73(2): 361-371. DOI: 10.1136/gutjnl-2023-330616
|
| [10] |
Fitch K, Bernstein S J, Aguilar M D, et al. The RAND/UCLA appropriateness method user's manual: MR-1269-DG-Ⅻ/RE[R]. Santa Monica: RAND, 2001.
|
| [11] |
Ghoneim S, Wang J S, El Hage Chehade N, et al. Diagno-stic accuracy of the proton pump inhibitor test in gastroesophageal reflux disease and noncardiac chest pain: a systematic review and meta-analysis[J]. J Clin Gastroenterol, 2023, 57(4): 380-388. DOI: 10.1097/MCG.0000000000001686
|
| [12] |
Chiba N, De Gara C J, Wilkinson J M, et al. Speed of healing and symptom relief in grade Ⅱ to Ⅳ gastroesophageal reflux disease: a meta-analysis[J]. Gastroenterology, 1997, 112(6): 1798-1810. DOI: 10.1053/gast.1997.v112.pm9178669
|
| [13] |
Zheng Z D, Luo Y Y, Li J, et al. Randomised trials of proton pump inhibitors for gastro-oesophageal reflux disease in patients with asthma: an updated systematic review and meta-analysis[J]. BMJ Open, 2021, 11(8): e043860. DOI: 10.1136/bmjopen-2020-043860
|
| [14] |
Boghossian T A, Rashid F J, Thompson W, et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults[J]. Cochrane Database Syst Rev, 2017, 3(3): CD011969.
|
| [15] |
Lundell L R, Dent J, Bennett J R, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification[J]. Gut, 1999, 45(2): 172-180. DOI: 10.1136/gut.45.2.172
|
| [16] |
Visaggi P, Del Corso G, Gyawali C P, et al. Ambulatory pH-impedance findings confirm that grade B esophagitis provides objective diagnosis of gastroesophageal reflux disease[J]. Am J Gastroenterol, 2023, 118(5): 794-801. DOI: 10.14309/ajg.0000000000002173
|
| [17] |
Armstrong D, Bennett J R, Blum A L, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement[J]. Gastroenterology, 1996, 111(1): 85-92. DOI: 10.1053/gast.1996.v111.pm8698230
|
| [18] |
Rusu R I, Fox M R, Tucker E, et al. Validation of the Lyon classification for GORD diagnosis: acid exposure time assessed by prolonged wireless pH monitoring in healthy controls and patients with erosive oesophagitis[J]. Gut, 2021, 70(12): 2230-2237. DOI: 10.1136/gutjnl-2020-323798
|
| [19] |
Yadlapati R, Masihi M, Gyawali C P, et al. Ambulatory reflux monitoring guides proton pump inhibitor discontinuation in patients with gastroesophageal reflux symptoms: a clinical trial[J]. Gastroenterology, 2021, 160(1): 174-182. e1. DOI: 10.1053/j.gastro.2020.09.013
|
| [20] |
Hasak S, Yadlapati R, Altayar O, et al. Prolonged wireless pH monitoring in patients with persistent reflux symptoms despite proton pump inhibitor therapy[J]. Clin Gastroenterol Hepatol, 2020, 18(13): 2912-2919. DOI: 10.1016/j.cgh.2020.01.031
|
| [21] |
Wiener G J, Morgan T M, Copper J B, et al. Ambulatory 24-hour esophageal pH monitoring. Reproducibility and variability of pH parameters[J]. Dig Dis Sci, 1988, 33(9): 1127-1133. DOI: 10.1007/BF01535789
|
| [22] |
Sifrim D, Roman S, Savarino E, et al. Normal values and regional differences in oesophageal impedance-pH metrics: a consensus analysis of impedance-pH studies from around the world[J]. Gut, 2021, 70(8): 1441-1449. DOI: 10.1136/gutjnl-2020-322627
|
| [23] |
Rengarajan A, Savarino E, Della Coletta M, et al. Mean nocturnal baseline impedance correlates with symptom outcome when acid exposure time is inconclusive on esophageal reflux monitoring[J]. Clin Gastroenterol Hepatol, 2020, 18(3): 589-595. DOI: 10.1016/j.cgh.2019.05.044
|
| [24] |
Martinucci I, De Bortoli N, Savarino E, et al. Esophageal baseline impedance levels in patients with pathophysiological characteristics of functional heartburn[J]. Neurogastroen-terol Motil, 2014, 26(4): 546-555. DOI: 10.1111/nmo.12299
|
| [25] |
Frazzoni L, Frazzoni M, De Bortoli N, et al. Application of Lyon Consensus criteria for GORD diagnosis: evaluation of conventional and new impedance-pH parameters[J]. Gut, 2022, 71(6): 1062-1067. DOI: 10.1136/gutjnl-2021-325531
|
| [26] |
Argüero J, Sifrim D. Pathophysiology of gastro-oesophageal reflux disease: implications for diagnosis and management[J]. Nat Rev Gastroenterol Hepatol, 2024, 21(4): 282-293. DOI: 10.1038/s41575-023-00883-z
|
| [27] |
Carlson D A, Kahrilas P J, Simlote A, et al. Identifying hiatal hernia with impedance planimetry during esophageal distension testing[J]. Neurogastroenterol Motil, 2023, 35(2): e14470. DOI: 10.1111/nmo.14470
|
| [28] |
Shahsavari D, Smith M S, Malik Z, et al. Hiatal hernias associated with acid reflux: size larger than 2 cm matters[J]. Dis Esophagus, 2022, 35(8): doac001.
|
| [29] |
Luther J, Zarro S, Sagaram M, et al. Intermittent hiatus hernia on high-resolution manometry associates with abnormal reflux burden similar to persistent hiatus hernia[J]. Am J Gastroenterol, 2023, 118(11): 2071-2074. DOI: 10.14309/ajg.0000000000002353
|
| [30] |
Shi Z, Qi C, Chen Q, et al. Measurement of oesophageal hiatus surface area by multiplanar reconstruction of MDCT: relationship with lower oesophageal sphincter pressure and acid reflux[J]. Clin Radiol, 2023, 78(10): 789-794. DOI: 10.1016/j.crad.2023.05.014
|
| [31] |
Frazzoni M, Frazzoni L, Ribolsi M, et al. Applying Lyon Consensus criteria in the work-up of patients with proton pump inhibitory-refractory heartburn[J]. Aliment Pharmacol Ther, 2022, 55(11): 1423-1430. DOI: 10.1111/apt.16838
|
| [32] |
Zerbib F, Bredenoord A J, Fass R, et al. ESNM/ANMS consensus paper: diagnosis and management of refractory gastro-esophageal reflux disease[J]. Neurogastroenterol Motil, 2021, 33(4): e14075. DOI: 10.1111/nmo.14075
|
| [33] |
Gyawali C P, Tutuian R, Zerbib F, et al. Value of pH impedance monitoring while on twice-daily proton pump inhibitor therapy to identify need for escalation of reflux management[J]. Gastroenterology, 2021, 161(5): 1412-1422. DOI: 10.1053/j.gastro.2021.07.004
|
| [34] |
Charbel S, Khandwala F, Vaezi M F. The role of esophageal pH monitoring in symptomatic patients on PPI therapy[J]. Am J Gastroenterol, 2005, 100(2): 283-289. DOI: 10.1111/j.1572-0241.2005.41210.x
|
| [35] |
国家药品监督管理局药品审评中心. 国家药监局药审中心关于发布《胃食管反流病治疗药物临床试验技术指导原则》的通告(2024年第37号)[EB/OL]. (2024-07-16)[2024-08-24]. https://www.cde.org.cn/main/news/viewInfoCommon/3b919afd8c3868a901bc47302104f074.
Center for Drug Evaluation, NMPA. Notice of the Drug Evaluation Center of the National Medical Products Administra-tion on issuing the Technical Guidelines for Clinical Trials of Drugs for the Treatment of Gastroesophageal Reflux Disease (No. 37 of 2024)[EB/OL]. (2024-07-16)[2024-08-24]. https://www.cde.org.cn/main/news/viewInfoCom-mon/3b919afd8c3868a901bc47302104f074.
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