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

Is it GERD

Pdf Summary

This document discusses diagnostic testing for gastroesophageal reflux disease (GERD). It begins by presenting two patient cases and asks whether they have GERD based on their symptoms. The definition of GERD is provided as the reflux of gastric contents into the esophagus resulting in symptoms and/or complications. The document then discusses using a proton pump inhibitor (PPI) trial as an endpoint for diagnosis, with success rates for various symptoms. Endoscopy is recommended to assess for mucosal injury, Barrett's esophagus, and other diseases. Routine histology and esophageal pH monitoring are also discussed as diagnostic tests. Ambulatory pH monitoring parameters and normal/abnormal values are provided. The document also discusses post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) as measures of reflux clearance. Esophageal pH monitoring and symptom indices are described as well. Bravo 96-hour extended monitoring, mucosal impedance testing (MIT), esophageal high-resolution manometry (HRM), and other tests like Endoflip and ESMO are mentioned. The document discusses refractory symptoms both with and without prior workup and provides summary information on diagnostic tests such as abnormal esophageal acid exposure, reflux episodes, and diagnosis of GERD. It concludes by cautioning that there is no 100% accurate test for GERD, and diagnosis should be based on symptoms and objective findings while considering underlying functional disorders and other possible causes.

Keywords

diagnostic testing

gastroesophageal reflux disease

GERD

symptoms

proton pump inhibitor trial

endoscopy

esophageal pH monitoring

reflux clearance

refractory symptoms

functional disorders