Ambulatory Reflux Monitoring in GERD – Which Test Should be Performed and Should Therapy be Stopped?

Esophagus (L Gerson, Section Editor)

DOI: 10.1007/s11894-013-0316-6

Cite this article as:
Gawron, A.J. & Pandolfino, J.E. Curr Gastroenterol Rep (2013) 15: 316. doi:10.1007/s11894-013-0316-6
Part of the following topical collections:
  1. Topical Collection on Esophagus

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.

Keywords

Gastroesophageal reflux diseaseReflux monitoringProton pump inhibitorHeartburnpH testingImpedanceEndoscopy

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Medicine, The Feinberg School of MedicineNorthwestern UniversityChicagoUSA