PMID- 38145413
OWN - NLM
STAT- MEDLINE
DCOM- 20240322
LR  - 20240322
IS  - 1747-4132 (Electronic)
IS  - 1747-4124 (Linking)
VI  - 18
IP  - 1-3
DP  - 2024 Jan-Feb
TI  - Optimizing ambulatory reflux monitoring: current findings and future directions.
PG  - 13-24
LID - 10.1080/17474124.2023.2297919 [doi]
AB  - INTRODUCTION: Gastroesophageal reflux disease (GERD) is the most common diagnosis 
      seen in outpatient gastroenterology clinics. The diagnosis is made by a variable 
      combination of symptoms, response to acid suppressive therapy, endoscopic 
      evaluation, and pH testing. In this review, we evaluate how to utilize various 
      reflux testing in clinical practice based on current evidence. AREAS COVERED: 
      Ambulatory reflux monitoring is a recognized diagnostic tool for clinical 
      decision making in patients with/without established GERD, persistent reflux 
      symptoms, and lack of response to proton pump inhibitor (PPI) therapy. Standard 
      evaluation approaches include 24-hour pH or impedance monitoring via transnasal 
      catheter, prolonged (48 to 96 hour) wireless pH monitoring, and the recently 
      developed mucosal integrity testing. Testing using one of these methods allows 
      for measurement of acid exposure, frequency of reflux, and to phenotype patients 
      to personalize treatment recommendations. EXPERT OPINION: The primary goal of 
      future studies should be to simplify ambulatory reflux monitoring, reduce 
      diagnostic latency, improve patient tolerance, and to obtain clinical 
      outcomes-based studies. The current paradigm of reflux testing is vastly complex 
      with multiple modalities and shifting cutoffs of pH abnormality that lead to high 
      economic burden on the society.
FAU - Dasarathy, Dhweeja
AU  - Dasarathy D
AD  - School of Medicine, and Division of Gastroenterology, Hepatology and Nutrition, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Vaezi, Michael
AU  - Vaezi M
AD  - School of Medicine, and Division of Gastroenterology, Hepatology and Nutrition, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
FAU - Patel, Dhyanesh
AU  - Patel D
AD  - School of Medicine, and Division of Gastroenterology, Hepatology and Nutrition, 
      Vanderbilt University Medical Center, Nashville, TN, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231225
PL  - England
TA  - Expert Rev Gastroenterol Hepatol
JT  - Expert review of gastroenterology & hepatology
JID - 101278199
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - *Esophageal pH Monitoring
MH  - *Gastroesophageal Reflux/diagnosis/drug therapy
MH  - Electric Impedance
MH  - Proton Pump Inhibitors/therapeutic use
OTO - NOTNLM
OT  - Gastroesophageal reflux disease
OT  - ambulatory ph testing
OT  - endoscopy
OT  - mucosal integrity testing
OT  - wireless ph testing
EDAT- 2023/12/25 12:42
MHDA- 2024/03/22 06:44
CRDT- 2023/12/25 10:02
PHST- 2024/03/22 06:44 [medline]
PHST- 2023/12/25 12:42 [pubmed]
PHST- 2023/12/25 10:02 [entrez]
AID - 10.1080/17474124.2023.2297919 [doi]
PST - ppublish
SO  - Expert Rev Gastroenterol Hepatol. 2024 Jan-Feb;18(1-3):13-24. doi: 
      10.1080/17474124.2023.2297919. Epub 2023 Dec 25.