ACG Practice Guidelines: Esophageal Reflux Testing

Hirano, Ikuo; Richter, Joel E.
March 2007
American Journal of Gastroenterology;Mar2007, Vol. 102 Issue 3, p668
Academic Journal
Investigations and technical advances have enhanced our understanding and management of gastroesophageal reflux disease. The recognition of the prevalence and importance of patients with endoscopy-negative reflux disease as well as those refractory to proton pump inhibitor therapy have led to an increasing need for objective tests of esophageal reflux. Guidelines for esophageal reflux testing are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the Board of Trustees. Issues regarding the utilization of conventional, catheter-based pH monitoring are discussed. Improvements in the interpretation of esophageal pH recordings through the use of symptom-reflux association analyses as well as limitations gleaned from recent studies are reviewed. The clinical utility of pH recordings in the proximal esophagus and stomach is examined. Newly introduced techniques of duodenogastroesophageal reflux, wireless pH capsule monitoring and esophageal impedance testing are assessed and put into the context of traditional methodology. Finally, recommendations on the clinical applications of esophageal reflux testing are presented.


Related Articles

  • Effect of Proton Pump Inhibitor Therapy on Inflammatory Changes in the Gastric Cardia (Carditis). Shailender Singh; Ajay Bansal; Srinivas Puli; Sachin Wani; Sharad Mathur; Amit Rastogi // Digestive Diseases & Sciences;Sep2007, Vol. 52 Issue 9, p2178 

    Abstract  The etiology of inflammation of the gastric cardia (carditis) is controversial, and gastroesophageal reflux disease (GERD) and H. pylori infection have been proposed as etiological factors. This study aimed to investigate the effect of acid suppression on histological...

  • Stability of pantoprazole in 0.9% sodium chloride injection in polypropylene syringes. Johnson, Cary E. // American Journal of Health-System Pharmacy;11/15/2005, Vol. 62 Issue 22, p2410 

    Presents a study on the use of a proton-pump inhibitor pantoprazole in short-term medical management of erosive esophagitis associated with gastroesophageal reflux disease in the U.S. Guidelines for the initial preparation of the pantoprazole sodium for injection; Evaluation on the stability of...

  • Esophageal Acid Exposure Decreases Intraluminal Baseline Impedance Levels. Kessing, Boudewijn F; Bredenoord, Albert J; Weijenborg, Pim W; Hemmink, Gerrit J M; Loots, Clara M; Smout, A J P M // American Journal of Gastroenterology;Dec2011, Vol. 106 Issue 12, p2093 

    OBJECTIVES:Intraluminal baseline impedance levels are determined by the conductivity of the esophageal wall and can be decreased in gastroesophageal reflux disease (GERD) patients. The aim of this study was to investigate the baseline impedance in GERD patients, on and off proton pump inhibitor...

  • Prevalence and management of gastroesophageal reflux disease in children and adolescents: a nationwide cross-sectional observational study. Martigne, Léonie; Delaage, Pierre-Henri; Thomas-Delecourt, Florence; Bonnelye, Geneviève; Barthélémy, Philippe; Gottrand, Frédéric // European Journal of Pediatrics;Dec2012, Vol. 171 Issue 12, p1767 

    This cross-sectional observational study aimed to determine the nationwide prevalence of gastroesophageal reflux disease (GORD) in French children and adolescents. Four hundred four general practitioners and 180 paediatricians compiled a register of all children and adolescents ( n = 10,394,...

  • Non-erosive Reflux Disease and Atypical Gastro-oesophageal Reflux Disease Manifestations: Treatment Results. Galmiche, Jean Paul // Drugs;2006 Supplement 1, Vol. 66, p7 

    Gastro-oesophageal reflux disease (GERD) is a widespread complex disorder that may be responsible for a variety of different symptoms and clinical features. Despite the presence of symptoms, the majority of patients do not have endoscopic lesions of oesophagitis. Non-erosive reflux disease...

  • Acid Inhibition in GERD–How Much is Enough? Achem, Sami R. // American Journal of Gastroenterology;Jun2004, Vol. 99 Issue 6, p997 

    Gastric acid plays a fundamental role in the development of mucosal injury and symptoms in gastro-esophageal reflux disease(GERD). In this issue of theJournal, Milkes et al report the inability of proton pump inhibitor (PPIs) therapy to“normalize” 24-hour intraesophageal pH...

  • Proton Pump Inhibitor Therapy for Suspected GERD-Related Chronic Laryngitis: A Meta-Analysis of Randomized Controlled Trials. Qadeer, Mohammed A.; Phillips, Christopher O.; Lopez, A. Rocio; Steward, David L.; Noordzij, J. Pieter; Wo, John M.; Suurna, Maria; Havas, Thomas; Howden, Colin W.; Vaezi, Michael F. // American Journal of Gastroenterology;Nov2006, Vol. 101 Issue 11, p2646 

    OBJECTIVE: The role of proton pump inhibitors (PPIs) in suspected GERD-related chronic laryngitis (CL) is controversial. Hence, we performed a meta-analysis of the existing randomized controlled trials (RCTs) to evaluate the efficacy of PPIs in this disorder. METHODS: Data extracted from MEDLINE...

  • Favorable response to proton pump inhibitors doesn't necessarily diagnose GERD.  // Journal of Family Practice;Sep2004, Vol. 53 Issue 9, p688 

    This article presents a meta-analysis to determine whether a favorable response to therapy with a proton pump inhibitor (PPI) can confirm the diagnosis of gastroesophageal reflux disease (GERD). The investigators performed a meta-analysis of all studies that compared treatment of symptomatic...

  • Outcomes of fundoplication: causes for, concern, newer options. Hassall, E. // Archives of Disease in Childhood;Oct2005, Vol. 90 Issue 10, p1047 

    Antireflux surgery has been a mainstay of treatment for gastro-oesophaged reflux disease in children for some 40 years. In recent years, enthusiasm for antireflux surgery seems only to have increased, despite its often poor outcome, and the availability of highly effective medical therapy in the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics