Abstract
The diagnosis of gastroesophageal reflux disease (GERD) is frequently based on symptoms and upper endoscopy only, with a wrong diagnosis of GERD that occurs in up to 30 % of patients. Since a correct diagnosis of GERD is necessary to avoid inappropriate medical therapy and to properly select patients who might benefit from laparoscopic antireflux surgery, the proper evaluation of patients with symptoms suggestive of GERD should always include esophageal manometry and ambulatory 24-h pH monitoring.
Conflict of Interest
The authors have no conflicts of interest to declare.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Selected Reading
Amano Y, Ishimura N, Furuta K, Okita K, Masaharu M, Azumi T, Ose T, Koshino K, Ishihara S, Adachi K, Kinoshita Y. Interobserver agreement on classifying endoscopic diagnoses of non erosive esophagitis. Endoscopy. 2006;38:1032–5.
Bais JE, Samsom M, Boudesteijn EA, van Rijk PP, Akkermans LM, Gooszen HG. Impact of delayed gastric emptying on the outcome of antireflux surgery. Ann Surg. 2001;234:139–46.
Bello B, Zoccali M, Gullo R, Allaix ME, Herbella FA, Gasparaitis A, Patti MG. Gastroesophageal reflux disease and antireflux surgery-what is the proper preoperative work-up? J Gastrointest Surg. 2013;17:14–20.
Blonski W, Vela MF, Castell DO. Comparison of reflux frequency during prolonged multichannel intraluminal impedance and pH monitoring on and off acid suppression therapy. J Clin Gastroenterol. 2009;43(9):816–20.
Campos GM, Peters JH, DeMeester TR, Oberg S, Crookes PF, Tan S, DeMeester SR, Hagen JA, Bremner CG. Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg. 1999;3:292–300.
Chen MY, Ott DJ, Sinclair JW, Wu WC, Gelfand DW. Gastroesophageal reflux disease: correlation of esophageal pH testing and radiographic findings. Radiology. 1992;185:483–6.
Dallemagne B, Weerts J, Markiewicz S, Dewandre JM, Wahlen C, Monami B, Jehaes C. Clinical results of laparoscopic fundoplication at ten years after surgery. Surg Endosc. 2006;20:159–65.
Diener U, Patti MG, Molena D, Fisichella PM, Way LV. Esophageal dysmotility and gastroesophageal reflux disease. J Gastrointest Surg. 2001;5:260–5.
Galvani C, Fisichella PM, Gorodner MV, Perretta S, Patti MG. Symptoms are a poor indicator of reflux status after fundoplication for gastroesophageal reflux disease: role of esophageal function tests. Arch Surg. 2003;138:514–8.
Håkanson BS, Berggren P, Granqvist S, Ljungqvist O, Thorell A. Comparison of wireless 48-h (Bravo) versus traditional ambulatory 24-h esophageal pH monitoring. Scand J Gastroenterol. 2009;44(3):276–83.
Hirano I, Richter JE. Practice Parameters Committee of the American College of Gastroenterology. ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol. 2007;102:668–85.
Jamieson JR, Stein HJ, DeMeester TR, Bonavina L, Schwizer W, Hinder RA, Albertucci M. Ambulatory 24-h esophageal pH monitoring: normal values, optimal thresholds, specificity, sensitivity and reproducibility. Am J Gastroenterol. 1992;87:1102–11.
Johnson F, Joelsson B, Gudmundsson K, Greiff L. Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease. Scan J Gastroenterol. 1987;22:714–8.
Kahrilas PJ, Ghosh SK, Pandolfino JE. Esophageal motility disorders in terms of pressure topography: the Chicago classification. J Clin Gastroenterol. 2008;42:627–35.
Khajanchee YS, Hong D, Hansen PD, Swanstrom LL. Outcomes of antireflux surgery in patients with normal preoperative 24-hour pH test results. Am J Surg. 2004;187:599–603.
Lord RV, Kaminski A, Oberg S, Bowrey DJ, Hagen JA, DeMeester SR, Sillin LF, Peters JH, Crookes PF, DeMeester TR. Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg. 2002;6:3–9.
Mainie I, Tutuian R, Agrawal A, Adams D, Castell DO. Combined multichannel intraluminal impedance-pH monitoring to select patients with persistent gastro-esophageal reflux for laparoscopic Nissen fundoplication. Br J Surg. 2006;93:1483–7.
Ott DJ. Gastroesophageal reflux. What is the role of barium studies? Am J Roentgenol. 1994;162:627–9.
Patti MG, Debas HT, Pellegrini CA. Clinical and functional characterization of high gastroesophageal reflux. Am J Surg. 1993;165:163–6.
Patti MG, Arcerito M, Tong J, de Pinto M, de Bellis M, Wang A, Feo CV, Mulvihill SJ, Way LW. Importance of preoperative and postoperative pH monitoring in patients with esophageal achalasia. J Gastrointest Surg. 1997;1:505–10.
Patti MG, Arcerito M, Feo CV, Worth S, De Pinto M, Gibbs VC, Gantert W, Tyrrell D, Ferrell LF, Way LW. Barrett’s esophagus: a surgical disease. J Gastrointest Surg. 1999;3:397–403.
Patti MG, Arcerito M, Tamburini A, Diener U, Feo CV, Safadi B, Fisichella P, Way LW. Effect of laparoscopic fundoplication on gastroesophageal reflux disease-induced respiratory symptoms. J Gastrointest Surg. 2000;4:143–9.
Patti MG, Diener U, Tamburini A, Molena D, Way LW. Role of esophageal function tests in the diagnosis of gastroesophageal reflux disease. Dig Dis Sci. 2001;46:597–602.
Patti MG, Molena D, Fisichella PM, Perretta S, Way LW. Gastroesophageal reflux disease and chest pain. Results of laparoscopic antireflux surgery. Surg Endosc. 2002;16:563–6.
Pellegrini CA. Delayed gastric emptying in patients with abnormal gastroesophageal reflux. Ann Surg. 2001;234:147–8.
Pellegrini CA, Broderick WC, Van Dyke D, Way LW. Diagnosis and treatment of gastric emptying disorders. Clinical usefulness of radionuclide measurements of gastric emptying. Am J Surg. 1983;145:143–51.
Richter JE. Typical and atypical presentations of gastroesophageal reflux disease. The role of esophageal testing in diagnosis and management. Gastroenterol Clin North Am. 1996;25:75–102.
Streets CG, DeMeester TR. Ambulatory 24-hour pH monitoring: why, when, and what to do. J Clin Gastroenterol. 2003;37:14–22.
Tamhankar AP, Peters JH, Portale G, Hsieh CC, Hagen JA, Bremner CG, DeMeester TR. Omeprazole does not reduce gastroesophageal reflux: new insights using multichannel intraluminal impedance technology. J Gastrointest Surg. 2004;8:890–7.
Tutuian R, Mainie I, Agrawal A, Adams D, Castell DO. Nonacid reflux in patients with chronic cough on acid-suppressive therapy. Chest. 2006;130:386–91.
Viljakka M, Saali K, Koskinen M, et al. Antireflux surgery enhances gastric emptying. Arch Surg. 1999;134:18–21.
Wayman J, Myers JC, Jamieson GG. Preoperative gastric emptying and patterns of reflux as predictors of outcome after laparoscopic fundoplication. Br J Surg. 2007;94:592–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Allaix, M.E., Borraez, B.A., Patti, M.G. (2014). Gastroesophageal Reflux Disease: Diagnostic Evaluation. In: Fisichella, P., Allaix, M., Morino, M., Patti, M. (eds) Esophageal Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-04337-1_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-04337-1_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-04336-4
Online ISBN: 978-3-319-04337-1
eBook Packages: MedicineMedicine (R0)