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

BACKGROUND AND AIMS: Gastroesophageal reflux disease (GERD) is common and heterogeneous, with growing recognition of nonerosive reflux disease (NERD) and extraesophageal manifestations in Asia. The variations in diagnostic resources and clinical practice necessitate context-specific, evidence-based guidance. Thus, we developed a guideline that aims to standardize the diagnosis and management of GERD in Vietnam. METHODS: A multidisciplinary panel conducted a structured literature search and developed consensus statements using a modified Delphi process. Evidence quality and recommendation strength were evaluated using the GRADE framework. RESULTS: Twenty recommendations address the diagnostic and therapeutic strategies. Upper endoscopy and ambulatory reflux monitoring are recommended for selected patients, whereas high-resolution manometry is advised for those with refractory symptoms and for preintervention evaluation. Empiric proton pump inhibitor (PPI) testing alone is insufficient for diagnosis. Lifestyle modification and optimized PPI therapy remain the first-line treatments. Standard-duration PPI therapy is recommended for patients with NERD and erosive esophagitis, with optimization required before defining refractory GERD. Potassium-competitive acid blockers may be considered as alternatives. Endoscopic and surgical interventions are reserved for patients with objective reflux and persistent symptoms despite undergoing optimized medical therapy. CONCLUSION: The developed guideline provides evidence-based, context-adapted recommendations to standardize GERD care in Vietnam.