PMID- 17013449
OWN - NLM
STAT- MEDLINE
DCOM- 20070119
LR  - 20091216
IS  - 1841-8724 (Print)
IS  - 1841-8724 (Linking)
VI  - 15
IP  - 3
DP  - 2006 Sep
TI  - Update in the diagnosis of gastroesophageal reflux disease.
PG  - 243-7
AB  - Clinical manifestations of gastroesophageal reflux disease (GERD) include 
      heartburn, regurgitation, dysphagia, chest pain, cough and other extraesophageal 
      symptoms. GERD is known to cause erosive esophagitis, Barrett esophagus and has 
      been linked to the development of adenocarcinoma of the esophagus. Currently 
      upper gastrointestinal endoscopy is the main clinical tool for visualizing 
      esophageal lesions. Since the majority of GERD patients do not have endoscopic 
      visible lesions other methods are required to document the abnormal acid exposure 
      in the distal esophagus. For many clinicians ambulatory esophageal pH monitoring 
      is the gold standard in diagnosing GERD since it quantifies distal esophageal 
      acid exposure and allows the evaluation of the relationship between symptoms and 
      acid reflux. The availability of highly selective gastric acid suppressive 
      therapy led to the introduction of short trials of proton pump inhibitors (PPI) 
      to diagnose GERD. PPI trials are often used as a first line diagnostic tool in 
      clinical practice and in particular in the primary care settings. This 
      development has a major influence in the type of patients referred to 
      gastrointestinal specialists, the current trend being that gastroenterologists 
      are asked to evaluate an increasing number of patients with persistent GERD 
      symptoms while on PPI therapy. In these patients the question is whether the 
      persistent symptoms are or not associated with reflux (acid or non-acid). In the 
      recent years combined multichannel intraluminal impedance and pH (MII-pH) 
      monitoring has become a clinical tool that permits the clarification of the 
      mechanisms underlying the persistent symptoms on acid suppressive therapy.
FAU - Tutuian, Radu
AU  - Tutuian R
AD  - Division of Gastroenterology and Hepatology, University Hospital Zurich, 
      Ramistrasse 100, CH-8091 Zurich, Switzerland. radu.tutuian@usz.ch
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Romania
TA  - J Gastrointestin Liver Dis
JT  - Journal of gastrointestinal and liver diseases : JGLD
JID - 101272825
SB  - IM
MH  - Gastroesophageal Reflux/*diagnosis
MH  - Humans
RF  - 20
EDAT- 2006/10/03 09:00
MHDA- 2007/01/20 09:00
CRDT- 2006/10/03 09:00
PHST- 2006/10/03 09:00 [pubmed]
PHST- 2007/01/20 09:00 [medline]
PHST- 2006/10/03 09:00 [entrez]
AID - 6 [pii]
PST - ppublish
SO  - J Gastrointestin Liver Dis. 2006 Sep;15(3):243-7.