Vietnam Association of Gastroenterology (VNAGE) guideline on the management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a common condition with increasing recognition of nonerosive reflux disease and extraesophageal manifestations in Asia. The Vietnam Association of Gastroenterology developed 20 recommendations to standardize GERD diagnosis and management. Upper endoscopy and ambulatory reflux monitoring are recommended only for selected patients, while high-resolution manometry is appropriate for patients with refractory disease. Empiric proton pump inhibitor (PPI) testing alone is insufficient for diagnosis. First-line treatment consists of lifestyle modifications and optimized PPI therapy. Standard-duration PPI therapy is recommended for patients with nonerosive reflux disease and erosive esophagitis. Endoscopic and surgical interventions are reserved for patients with objective reflux and persistent symptoms despite optimized medical therapy.