Gastro-oesophageal reflux disease — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 61 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting gastro- oesophageal reflux disease or death from gastro-oesophageal reflux disease with the circumstances of a person's relevant service:

1. (1)
   having a hiatus hernia at the time of the clinical onset of gastro- oesophageal reflux disease;
2. (2)
   being overweight or obese at the time of the clinical onset of gastro- oesophageal reflux disease;

   Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

3. (3)
   having smoked tobacco products: (a) in an amount of at least 1.5 pack-years before the clinical onset of gastro-oesophageal reflux disease; and (b) commencing at least 5 years before the clinical onset of gastro- oesophageal reflux disease; and if smoking has ceased before the clinical onset of gastro-oesophageal reflux disease, then that onset occurred within 1 year of cessation;

   Note: one pack-year is defined in the Schedule 1 - Dictionary.

4. (4)
   consuming an average of at least 300 grams of alcohol per week for at least the 1 year before the clinical onset of gastro-oesophageal reflux disease;

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

5. (5)
   undergoing surgery to the region of the oesophageal hiatus or surgery involving the fundus or body of the stomach, within the 6 months before the clinical onset of gastro-oesophageal reflux disease;

   Note: Examples of surgery include oesophageal dilatation, bariatric surgery (such as laparoscopic adjustable gastric banding or laparoscopic sleeve gastrectomy) and per oral endoscopic myotomy (POEM).

6. (6)
   taking a drug from the Specified List 1 of drugs at the time of the clinical onset of gastro-oesophageal reflux disease;

   Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.

7. (7)
   having a disease from the specified list of diseases at the time of the clinical onset of gastro-oesophageal reflux disease;

   Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

8. (8)
   being pregnant at the time of the clinical onset of gastro-oesophageal reflux disease;
9. (9)
   having diabetes mellitus at the time of the clinical onset of gastro- oesophageal reflux disease;
10. (10)
    performing or practising as a wind instrument musician: (a) for an average of at least 25 hours per week; and (b) for a cumulative period of at least 1 year before the clinical onset of gastro-oesophageal reflux disease; and if those activities have ceased before the clinical onset of gastro- oesophageal reflux disease, then that onset occurred within 30 days of cessation;
11. (11)
    having a hiatus hernia at the time of the clinical worsening of gastro- oesophageal reflux disease;
12. (12)
    being overweight or obese at the time of the clinical worsening of gastro-oesophageal reflux disease;

    Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

13. (13)
    having smoked tobacco products: (a) in an amount of at least 1.5 pack-years before the clinical worsening of gastro-oesophageal reflux disease; and (b) commencing at least 5 years before the clinical worsening of gastro-oesophageal reflux disease; and if smoking has ceased before the clinical worsening of gastro- oesophageal reflux disease, then that worsening occurred within 1 year of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

14. (14)
    consuming an average of at least 300 grams of alcohol per week for at least the 1 year before the clinical worsening of gastro-oesophageal reflux disease;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

15. (15)
    undergoing surgery to the region of the oesophageal hiatus or surgery involving the fundus or body of the stomach, within the 6 months before the clinical worsening of gastro-oesophageal reflux disease;

    Note: Examples of surgery include oesophageal dilatation, bariatric surgery (such as laparoscopic adjustable gastric banding or laparoscopic sleeve gastrectomy) and per oral endoscopic myotomy (POEM).

16. (16)
    taking a drug from the Specified List 1 of drugs at the time of the clinical worsening of gastro-oesophageal reflux disease;

    Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.

17. (17)
    having a disease from the specified list of diseases at the time of the clinical worsening of gastro-oesophageal reflux disease;

    Note: specified list of diseases is defined in the Schedule 1 - Dictionary.

18. (18)
    being pregnant at the time of the clinical worsening of gastro- oesophageal reflux disease;
19. (19)
    having diabetes mellitus at the time of the clinical worsening of gastro- oesophageal reflux disease;
20. (20)
    performing or practising as a wind instrument musician: (a) for an average of at least 25 hours per week; and (b) for a cumulative period of at least 1 year before the clinical worsening of gastro-oesophageal reflux disease; and if those activities have ceased before the clinical worsening of gastro- oesophageal reflux disease, then that worsening occurred within 30 days of cessation;
21. (21)
    having a disorder of mental health from the specified list of disorders of mental health at the time of the clinical worsening of gastro- oesophageal reflux disease;

    Note: specified list of disorders of mental health is defined in the Schedule 1 - Dictionary.

22. (22)
    taking orally a drug from the Specified List 2 of drugs at the time of the clinical worsening of gastro-oesophageal reflux disease;

    Note: Specified List 2 of drugs is defined in the Schedule 1 - Dictionary.

23. (23)
    taking orally a drug which is associated in the individual with the clinical worsening of gastro-oesophageal reflux disease during drug therapy and either: (a) the improvement of gastro-oesophageal reflux disease within 3 months of discontinuing or tapering drug therapy; or (b) the clinical worsening of gastro-oesophageal reflux disease on rechallenge with the same drug; and where the drug was being taken at the time of the clinical worsening of gastro-oesophageal reflux disease;
24. (24)
    inability to obtain appropriate clinical management for gastro- oesophageal reflux disease;

Aggravation-only factors: the factors in subsections 9(11) to 9(24) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.