Chinese expert consensus on gastroesophageal reflux disease in 2020.

A meta-analysis of 1437 patients from 14 RCTs in China showed that prokinetics combined with PPI were more effective in alleviating symptoms than PPI monotherapy; however, no significant intergroup differences were observed in the mucosal healing rate.104 B Statement 16: Endoscopic radiofrequency ablation (RFA) can improve the GERD symptoms b B Overall agreement: A+, 30.0%; A, 60.0% b B Level of evidence: Moderate b Endoscopic treatments for GERD include endoscopic RFA, transoral incisionless fundoplication (TIF) and anti-reflux mucosectomy (ARMS). Gastroesophageal reflux disease (GERD) is common in clinical practice and its prevalence differs significantly in different countries and regions. The results showed that MSA was superior to PPI in reducing reflux symptoms and had fewer complications.122 A meta-analysis of 19 studies in which MSA was used to treat GERD has revealed that MSA and fundoplication are both effective, and there are no significant differences between them with respect to the reduction of PPI use and improvement of patients' QoL, and only 13.2% of patients require PPI after MSA.123 At present, RCTs and long-term follow-up studies of MSA are scarce; therefore, more clinical evidence is required. It was observed that in 308 patients with upper gastrointestinal symptoms the sensitivity and specificity of the reflux disease questionnaire (RDQ) in diagnosing GERD were 62% and 67%, respectively; while those of the gastroesophageal reflux disease questionnaire (GerdQ) were 65% and 71%, respectively.24,25 The diagnostic value of both questionnaires is higher in patients with typical reflux symptoms than in those with atypical symptoms. [Extracted from the article]