Korean J Gastroenterol.  2017 Feb;69(2):96-101. 10.4166/kjg.2017.69.2.96.

A Review of Diagnosis of GERD

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. jidmd@uuh.ulsan.kr

Abstract

The prevalence of gastroesophageal reflux disease (GERD) and the incidence of some of its complications have risen strikingly over the last few decades. With the accumulation in our understanding on the pathophysiology of GERD along with the development of proton pump inhibitors, the diagnostic and therapeutic approaches to the GERD have changed dramatically over the past decade. However, The GERD still poses a problem to many clinicians since the spectrum of the disease has evolved to encompass more challenging presentations such as refractory GERD and extraesophageal manifestations. The aim of this article was to provide a review of available current diagnostic tests of the GERD, includes proton pump inhibitor test, ambulatory pH monitoring, impedance pH monitoring, mucosa impedance, and high resolution manometry. This review discusses different modalities for the work up of GERD.

Keyword

Gastroesophageal reflux disease; Proton pump inhibitor test; Esophageal pH monitoring; Impedance pH monitoring; Mucosa impedance

MeSH Terms

Diagnosis*
Diagnostic Tests, Routine
Electric Impedance
Esophageal pH Monitoring
Gastroesophageal Reflux*
Hydrogen-Ion Concentration
Incidence
Manometry
Mucous Membrane
Prevalence
Proton Pump Inhibitors
Proton Pumps
Proton Pump Inhibitors
Proton Pumps

Reference

References

1. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997; 112:1448–1456.
Article
2. Vela MF. Diagnostic workup of GERD. Gastrointest Endoscopy Clin N Am. 2014; 24:655–666.
Article
3. Min BH, Huh KC, Jung HK, et al. Prevalence of uninvestigated dyspepsia and gastroesophageal reflux disease in Korea: a population-based study using the Rome III criteria. Dig Dis Sci. 2014; 59:2721–2729.
Article
4. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidencebased consensus. Am J Gastroenterol. 2006; 101:1900–1920.
Article
5. Klauser AG, Schindlbeck NE, Müller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990; 335:205–208.
Article
6. Numans ME, Lau J, de Wit NJ, Bonis PA. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a metaanalysis of diagnostic test characteristics. Ann Intern Med. 2004; 140:518–522.
7. Gasiorowska A, Fass R. The proton pump inhibitor (PPI) test in GERD: does it still have a role? J Clin Gastroenterol. 2008; 42:867–874.
8. Aanen MC, Weusten BL, Numans ME, de Wit NJ, Baron A, Smout AJ. Diagnostic value of the proton pump inhibitor test for gas-tro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther. 2006; 24:1377–1384.
Article
9. Gatta L, Vaira D, Sorrenti G, Zucchini S, Sama C, Vakil N. Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2007; 25:385–392.
Article
10. Qadeer MA, Phillips CO, Lopez AR, et al. Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a metaanalysis of randomized controlled trials. Am J Gastroenterol. 2006; 101:2646–2654.
Article
11. El-Serag HB, Lee P, Buchner A, Inadomi JM, Gavin M, McCarthy DM. Lansoprazole treatment of patients with chronic idiopathic laryngitis: a placebo-controlled trial. Am J Gastroenterol. 2001; 96:979–983.
Article
12. Sontag SJ, O'Connell S, Khandelwal S, et al. Asthmatics with gastroesophageal reflux: long term results of a randomized trial of medical and surgical antireflux therapies. Am J Gastroenterol. 2003; 98:987–999.
Article
13. Noordzij JP, Khidr A, Evans BA, et al. Evaluation of omeprazole in the treatment of reflux laryngitis: a prospective, placebo-controlled, randomized, double-blind study. Laryngoscope. 2001; 111:2147–2151.
Article
14. Eherer AJ, Habermann W, Hammer HF, Kiesler K, Friedrich G, Krejs GJ. Effect of pantoprazole on the course of reflux-associated laryngitis: a placebo-controlled double-blind crossover study. Scand J Gastroenterol. 2003; 38:462–467.
Article
15. Garrigues V, Gisbert L, Bastida G, et al. Manifestations of gastroesophageal reflux and response to omeprazole therapy in patients with chronic posterior laryngitis: an evaluation based on clinical practice. Dig Dis Sci. 2003; 48:2117–2123.
Article
16. Vaezi MF, Richter JE, Stasney CR, et al. Treatment of chronic posterior laryngitis with esomeprazole. Laryngoscope. 2006; 116:254–260.
Article
17. Chang AB, Lasserson TJ, Kiljander TO, Connor FL, Gaffney JT, Garske LA. Systematic review and metaanalysis of randomised controlled trials of gastro-oesophageal reflux interventions for chronic cough associated with gastro-oesophageal reflux. BMJ. 2006; 332:11–17.
Article
18. Qadeer MA, Phillips CO, Lopez AR, et al. Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a metaanalysis of randomized controlled trials. Am J Gastroenterol. 2006; 101:2646–2654.
Article
19. Johansson J, Johnsson F, Joelsson B, Florén CH, Walther B. Outcome 5 years after 360 degree fundoplication for gas-tro-oesophageal reflux disease. Br J Surg. 1993; 80:46–49.
20. Dent J, Brun J, Fendrick AM, et al. An evidencebased appraisal of reflux disease management – the genval workshop report. Gut. 1998; 44(Suppl 2):S1–S16.
Article
21. Charbel S, Khandwala F, Vaezi MF. The role of esophageal pH monitoring in symptomatic patients on PPI therapy. Am J Gastroenterol. 2005; 100:283–289.
Article
22. Spechler SJ, Lee E, Ahnen D, et al. Longterm outcome of medical and surgical therapies for gastroesophageal reflux disease: fol-low-up of a randomized controlled trial. JAMA. 2001; 285:2331–2338.
23. Fock KM, Talley NJ, Fass R, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol. 2008; 23:8–22.
Article
24. Lee JH, Cho YK, Jeon SW, et al. Guidelines for the treatment of gastroesophageal reflux disease. Korean J Gastroenterol. 2011; 57:57–66.
Article
25. DeVault KR, Castell DO. American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005; 100:190–200.
Article
26. American Gastroenterological Association. Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology. 2011; 140:1084–1091.
Article
27. Hirano I, Richter JE. Practice Parameters Committee of the American College of Gastroenterology. ACG practice guidelines: esophageal reflux testing. Am J Gastroenterol. 2007; 102:668–685.
Article
28. Karamanolis G, Triantafyllou K, Psatha P, et al. Bravo 48-hour wireless pH monitoring in patients with noncardiac chest pain. Objective gastroesophageal reflux disease parameters predict the responses to proton pump inhibitors. J Neurogastroenterol Motil. 2012; 18:169–173.
Article
29. Sung HJ, Chung WC, Roh JW, et al. Prediction of the response to proton pump inhibitor treatment using wireless ambulatory pH monitoring in patients with globus sense. Korean J Gastroenterol. 2015; 65:85–89.
Article
30. Bredenoord AJ, Weusten BL, Timmer R, Conchillo JM, Smout AJ. Addition of esophageal impedance monitoring to pH monitoring increases the yield of symptom association analysis in patients off PPI therapy. Am J Gastroenterol. 2006; 101:453–459.
Article
31. Sifrim D, Mittal R, Fass R, et al. Review article: acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms. Aliment Pharmacol Ther. 2007; 25:1003–1017.
Article
32. Farré R, van Malenstein H, De Vos R, et al. Short exposure of oesophageal mucosa to bile acids, both in acidic and weakly acidic conditions, can impair mucosal integrity and provoke dilated intercellular spaces. Gut. 2008; 57:1366–1374.
Article
33. Koek GH, Sifrim D, Lerut T, Janssens J, Tack J. Effect of the GABA(B) agonist baclofen in patients with symptoms and duode-no-gastro-oesophageal reflux refractory to proton pump inhibitors. Gut. 2003; 52:1397–1402.
Article
34. Savarino E, Zentilin P, Tutuian R, et al. The role of nonacid reflux in NERD: lessons learned from impedance-pH monitoring in 150 patients off therapy. Am J Gastroenterol. 2008; 103:2685–2693.
Article
35. Zerbib F, Duriez A, Roman S, Capdepont M, Mion F. Determinants of gastro-oesophageal reflux perception in patients with persistent symptoms despite proton pump inhibitors. Gut. 2008; 57:156–160.
Article
36. Shi Y, Tan N, Zhang N, et al. Predictors of proton pump inhibitor failure in nonerosive reflux disease: A study with impedance-pH monitoring and high-resolution manometry. Neurogastroenterol Motil. 2016; 28:674–679.
Article
37. Ates F, Yuksel ES, Higginbotham T, et al. Mucosal impedance discriminates GERD from non-GERD conditions. Gastroenterology. 2015; 148:334–343.
Article
38. Farré R, Blondeau K, Clement D, et al. Evaluation of oesophageal mucosa integrity by the intraluminal impedance technique. Gut. 2011; 60:885–892.
Article
39. Lehman MB, Clark SB, Ormsby AH, Rice TW, Richter JE, Goldblum JR. Squamous mucosal alterations in esophagectomy specimens from patients with end-stage achalasia. Am J Surg Pathol. 2001; 25:1413–1418.
Article
40. Kjellin AP, Ost AE, Pope CE 2nd. Histology of esophageal mucosa from patients with achalasia. Dis Esophagus. 2005; 18:257–261.
Article
41. Fass R, Sifrim D. Management of heartburn not responding to proton pump inhibitors. Gut. 2009; 58:295–309.
Article
42. Hershcovici T, Fass R. Step-by-step management of refractory gastroesophageal reflux disease. Dis Esophagus. 2013; 26:27–36.
43. Fujiwara Y, Arakawa T, Fass R. Gastroesophageal reflux disease and sleep. Gastroenterol Clin North Am. 2013; 42:57–70.
Article
44. Wilder-Smith C, Röhss K, Bokelund Singh S, Sagar M, Nagy P. The effects of dose and timing of esomeprazole administration on 24-h, daytime and nighttime acid inhibition in healthy volunteers. Aliment Pharmacol Ther. 2010; 32:1249–1256.
Article
45. Mainie I, Tutuian R, Shay S, et al. Acid and nonacid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring. Gut. 2006; 55:1398–1402.
Article
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