Browsing by Author "Philip Abraham"

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Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology
(Springer, 2019) Shobna J. Bhatia; Govind K. Makharia; Philip Abraham; Naresh Bhat; Ajay Kumar; D. Nageshwar Reddy; Uday C. Ghoshal; Vineet Ahuja; G. Venkat Rao; Krishnadas Devadas; Amit K. Dutta; Abhinav Jain; Saurabh Kedia; Rohit Dama; Rakesh Kalapala; Jose Filipe Alvares; Sunil Dadhich; Vinod Kumar Dixit; Mahesh Kumar Goenka; B.D. Goswami; Sanjeev K. Issar; Venkatakrishnan Leelakrishnan; Mohandas K. Mallath; Philip Mathew; Praveen Mathew; Subhashchandra Nandwani; Cannanore Ganesh Pai; Lorance Peter; A. V. Siva Prasad; Devinder Singh; Jaswinder Singh Sodhi; Randhir Sud; Jayanthi Venkataraman; Vandana Midha; Amol Bapaye; Usha Dutta; Ajay K. Jain; Rakesh Kochhar; Amarender S. Puri; Shivram Prasad Singh; Lalit Shimpi; Ajit Sood; Rajkumar T. Wadhwa
The Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The prevalence of GERD in India ranges from 7.6% to 30%, being < 10% in most population studies, and higher in cohort studies. The dietary factors associated with GERD include use of spices and non-vegetarian food. Helicobacter pylori is thought to have a negative relation with GERD; H. pylori negative patients have higher grade of symptoms of GERD and esophagitis. Less than 10% of GERD patients in India have erosive esophagitis. In patients with occasional or mild symptoms, antacids and histamine H2 receptor blockers (H2RAs) may be used, and proton pump inhibitors (PPI) should be used in patients with frequent or severe symptoms. Prokinetics have limited proven role in management of GERD. © 2019, Indian Society of Gastroenterology.
Vonoprazan in Management of Refractory Gastroesophageal Reflux Disease: An Indian Expert Group Consensus Statements
(Journal of Association of Physicians of India, 2025) Philip Abraham; Gourdas D. Choudhuri; Sharad Deshmukh; Manish Kak; Mangesh H. Tiwaskar; Rakesh K. Kochhar; Smita K. Sinha; Sarat Chandra Panigrahi; Rajeev Shandil; Molina Khanna; Ramesh Garg; Gurwant Singh Lamba; Monika Jain; Prateik Poddar; Ajay Mishra; Apurva Shah; Chetan V. Kantharia; Hardik Shah; Indraneel Saha; Khurshid Vazifdar; Lokesh Jain; Nitin Borse; Pallavi Garg; Manoj C.Anil Kumar; Manoj Sahu; Preetam Nath; Rajdeep Singh; Vikram Sahu; Sanjay Kumar Bandyopadhyay; Saurabh Jaiswal; Dinesh Patil; Shripad Bodas; Smit Vaghasia; Sudeep Khanna; Onkar C. Swami; Suneel Chakravarty; Vamsi K. Murthy; Vinod Kumar
Background: Approximately, 40% of gastroesophageal reflux disease (GERD) patients experience insufficient symptom relief from proton-pump inhibitors (PPI), resulting in PPI-refractory GERD (rGERD). Objective: To review the existing literature and develop an Indian expert group consensus statement on the place of vonoprazan in the management of rGERD. Materials and methods: A panel of 35 leading Indian gastroenterologists extensively reviewed the literature to develop consensus statements for the management of rGERD in Indian patients, with a focus on the newly available potassium-competitive acid blocker (P-CAB), vonoprazan. This process involved two structured meetings in which experts deliberated on literature reviews and draft statements, which were further rigorously discussed and modified. Consensus was achieved through a voting process employing a five-point Likert scale, with results meticulously documented. The final statements unanimously approved by all participants and subsequently developed into a comprehensive manuscript. Results: Based on the evidence, 14 statements were developed and confirmed by expert panelists for the assessment and management of rGERD. Among these 14 statements, 5 obtained Level A evidence, 4 received Level B, 4 were classified as Level C, and 1 as Level D. The consensus highlights the importance of symptom assessment, lifestyle modifications, and medication adherence, followed by a diagnostic procedure with upper gastrointestinal (GI) endoscopy. If needed, manometry or 24-hour pH impedance may be considered. Vonoprazan, a novel and reversible potassium-competitive acid blocker (P-CAB), has emerged as a potential alternative to proton pump inhibitors (PPIs), offering rapid, potent, and sustained acid suppression. Based on current evidence, a daily dose of 20 mg vonoprazan for 4-8 weeks is recommended as an initial treatment strategy for rGERD. Conclusion: The consensus endorses the use of vonoprazan to improve patient outcomes and quality of life, highlighting its important place in therapy for controlling rGERD in Indian patients. ©The Author(s).