Evaluation of esophageal function/pH in endoscopic therapy for gastroesophageal reflux disease.
Gastroesophageal reflux disease (GERD) typically requires lifelong medical therapy or surgery for the management of patients with frequent symptoms. The current standard of care is to prescribe medical therapy using proton pump inhibitors. Patients with moderate-to-severe GERD require extended/maintenance therapy. Until recently, the only alternative to this approach was surgical intervention. Endoscopic therapy for GERD has emerged as a second alternative strategy. Primary endpoints for all interventions have aimed at symptomatic control and reduction/discontinuance of medication use. For surgical and endoscopic therapies, however, there are other physiologic endpoints that have attempted to define changes in lower esophageal sphincter pressure and esophageal acid exposure. For patients being evaluated for endoscopic GERD therapy, the author recommends comprehensive esophageal testing and pH testing.
Johnson
David A
DA
Department of Gastroenterology, Eastern Virginia School of Medicine, 700 W. Olney Road, Norfolk, VA 23501, USA. dajevms@aol.com
D017115:Catheter Ablation / Q000379:methods*; D004943:Esophagogastric Junction / Q000601:surgery; D004945:Esophagoscopy / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D013536:Suture Techniques; D016896:Treatment Outcome