ASGE Masterclass: Barrett’s Esophagus, GERD and Esophageal Adenocarcinoma (On Demand)

Is it GERD

Pdf Summary

This document discusses diagnostic testing for gastroesophageal reflux disease (GERD). It begins by presenting two patient cases with potential GERD symptoms. The definition of GERD is then explained as the reflux of gastric contents into the esophagus that causes symptoms and/or complications. A PPI (proton pump inhibitor) trial is recommended as the endpoint for diagnosing GERD, with different success rates for various symptoms. Endoscopy is recommended to assess for mucosal injury, Barrett's esophagus, strictures, and other diseases. Routine histology can also be helpful. Esophageal pH monitoring and impedance testing are discussed as additional diagnostic tools. Various parameters like reflux episodes, PSPW index, and mean nocturnal baseline impedance (MNBI) are used to assess abnormal acid exposure and clearance from the esophagus. Symptom indices are described as well. The use of Bravo 96 hr extended monitoring and mucosal impedance testing is explained. ESMO is mentioned as a tool to rule out other diseases. Other diagnostic tools like high-resolution esophageal manometry (HREM) and Endoflip are briefly mentioned. The document also discusses refractory GERD symptoms and emphasizes that there is no 100% accurate test for GERD diagnosis. It concludes by reminding readers to consider underlying functional disorders and other conditions that may mimic GERD symptoms.

Keywords

diagnostic testing

gastroesophageal reflux disease

GERD

patient cases

proton pump inhibitor

endoscopy

mucosal injury

esophageal pH monitoring

impedance testing

reflux episodes