Ambulatory reflux monitoring in GERD - Which test should be performed and should therapy be stopped?

Andrew J. Gawron, John E. Pandolfino*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Diagnosing gastroesophageal reflux disease (GERD) often entails using a combination of patient symptoms, response to proton pump inhibitors (PPI), upper endoscopy, and ambulatory reflux testing. Each of these has limitations of which the clinician must be aware when managing patients with reflux symptoms. Ambulatory reflux monitoring, in particular, can potentially document the true presence of pathologic GERD. Consequently, reflux testing is often necessary in our evaluation of patients with reflux symptoms, and can be useful in distinguishing etiologies driving a lack of response to PPI therapy. Reflux testing results can be also used to guide appropriate PPI prescribing and clinical decision making for appropriate or unnecessary therapy. This review focuses on the limitations of our current diagnostic paradigm and highlights how reflux testing can be helpful in the diagnosis and management of patients with poor response to PPI therapy.

Original languageEnglish (US)
Article number316
JournalCurrent gastroenterology reports
Volume15
Issue number4
DOIs
StatePublished - Apr 2013

Keywords

  • Endoscopy
  • Gastroesophageal reflux disease
  • Heartburn
  • Impedance
  • PH testing
  • Proton pump inhibitor
  • Reflux monitoring

ASJC Scopus subject areas

  • Gastroenterology

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