Patients with refractory gastroesophageal reflux disease: diagnostic tools.
Patients with refractory to proton pump inhibitors (PPIs) gastroesophageal reflux disease (GERD) symptoms are approximately 40% and represent a very common problem in clinical practice. Many of these patients do not have GERD, but suffer from functional heartburn or hypersensitive esophagus. After thorough clinical evaluation and failure of escalation of PPI dose, diagnostic investigations include endoscopy, esophageal manometry, pH testing, esophageal Bilitec and esophageal impedance with pH monitoring.
Gastroenterology Unit, 2 Surgical Department, Aretaieion Hospital, Athens Medical School, Athens, Greece (Georgios P. Karamanolis.
Georgios P
GP
Karamanolis
Wingate Institute of Neurogastroentrology, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK (Daniel Sifrim).
Daniel
D
Sifrim
Refractory GERD; diagnosis