Diagnosis of GERD in typical and atypical manifestations

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Silvia Cesario
Serena Scida
Chiara Miraglia
Alberto Barchi
Antonio Nouvenne
Gioacchino Leandro
Tiziana Meschi
Gian Luigi de' Angelis
Francesco Di Mario

Keywords

GERD, diagnosis, typical manifestations, atypical manifestations, pH impedance, gastrin 17

Abstract

The manifestations of gastroesophageal reflux disease (GERD) have been recently classified into either esophageal or extra-esophageal syndromes. Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD. Endoscopy had a low sensitivity. Recently, the availability of multichannel intraluminal impedance and pH-monitoring (MII-pH) has modified the diagnostic approach towards atypical manifestations of GERD. There is a rising consensus that this technique should be considered as the gold standard for GERD diagnosis. Gastrin 17 (G-17) has been proposed as a non-invasive marker of GERD, due to the negative feedback between acid and the hormone. G17 levels seem able to identify patients with acid and non-acid reflux.

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