In Japan, with the increasing prevalence of gastroesophageal reflux disease (GERD) and growing public interest, the Japanese Society of Gastroenterology issued Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009 and a revised 2nd edition in 2015. A number of studies on GERD were subsequently conducted in Japan and abroad, and vonoprazan, a potassium-competitive acid blocker (P-CAB), became available for the first time in Japan in February 2015. The revised 3rd edition (Japanese edition), which incorporates new findings and information, was published in April 2021. These guidelines are summarized herein, particularly sections related to the treatment of GERD. The important clinical issues addressed in the present revision are (i) the introduction of treatment algorithms that classify GERD into reflux esophagitis and non-erosive reflux disease, (ii) the clarification of treatment algorithms based on to the severity of reflux esophagitis, and (iii) the positioning of vonoprazan in the treatment for GERD. The present guidelines propose vonoprazan as the initial/maintenance treatment for severe reflux esophagitis. They also recommend vonoprazan or PPI as an initial treatment for mild reflux esophagitis and recommended PPI and proposed vonoprazan as maintenance treatment. These updated guidelines offer the best clinical strategies for GERD patients in Japan and hope that they will be of global use for the diagnosis and treatment for GERD.

在日本，随着胃食管反流病（GERD）患病率的增加和公众兴趣的增加，日本胃肠病学会于2009年发布了GERD循证临床实践指南（第1版），并于2015年修订了第2版。随后在日本和国外开展了多项GERD研究，沃诺拉赞（一种钾离子竞争性酸阻滞剂（P-CAB））于2015年2月在日本首次上市。修订版第3版（日文版）于2021年4月发布，包含了新的发现和信息。本文总结了这些指南，尤其是与GERD治疗相关的章节。本修订版中解决的重要临床问题包括（i）引入将GERD分类为反流性食管炎和非糜烂性反流病的治疗方案，（ii）阐明基于反流性食管炎严重程度的治疗方案，和（iii）沃诺拉赞在GERD治疗中的定位。本指南建议将沃诺拉赞作为重度反流性食管炎的初始/维持治疗。他们还建议使用沃诺拉赞或PPI作为轻度反流性食管炎的初始治疗，并建议使用PPI和沃诺拉赞作为维持治疗。这些更新的指南为日本GERD患者提供了最佳的临床策略，并希望它们能在全球范围内用于GERD的诊断和治疗。