Utilization of wireless pH monitoring technologies: A summary of the proceedings from the Esophageal Diagnostic Working Group

J. E. Richter, J. E. Pandolfino, M. F. Vela, P. J. Kahrilas, B. E. Lacy, R. Ganz, W. Dengler, B. K. Oelschlager, J. Peters, K. R. Devault, R. Fass, C. P. Gyawali, J. Conklin, T. Demeester

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Gastroesophageal reflux disease (GERD) can be difficult to diagnose - symptoms alone are often not enough, and thus, objective testing is often required. GERD is a manifestation of pathologic levels of reflux into the esophagus of acidic, nonacidic, and/or bilious gastric content. However, in our current evidence-based knowledge approach, we only have reasonable outcome data in regards to acid reflux, as this particular type of refluxate predictably causes symptoms and mucosal damage, which improves with medical or surgical therapy. While there are data suggesting that nonacid reflux may be responsible for ongoing symptoms despite acid suppression in some patients, outcome data about this issue are limited. Therefore, this working group believes that it is essential to confirm the presence of acid reflux in patients with 'refractory' GERD symptoms or extraesophageal symptoms thought to be caused by gastroesophageal reflux before an escalation of antireflux therapy is considered. If patients do not have pathologic acid reflux off antisecretory therapy, they are unlikely to have clinically significant nonacid or bile reflux. Patients who do not have pathologic acid gastroesophageal reflux parameters on ambulatory pH monitoring then: (i) could attempt to discontinue antisecretory medications like proton pump inhibitors and H2-receptor antagonists (which are expensive and which carry risks - i.e. C. diff, etc.); (ii) may undergo further evaluation for other causes of their esophageal symptoms (e.g. functional heartburn or chest pain, eosinophilic esophagitis, gastroparesis, achalasia, other esophageal motor disorders); and (iii) can be referred to an ear, nose, and throat/pulmonary/allergy physician for assessment of non-GERD causes of their extraesophageal symptoms.

Original languageEnglish (US)
Pages (from-to)755-765
Number of pages11
JournalDiseases of the Esophagus
Issue number8
StatePublished - Nov 1 2013


  • Impedance
  • PH
  • Reflux monitoring

ASJC Scopus subject areas

  • Gastroenterology


Dive into the research topics of 'Utilization of wireless pH monitoring technologies: A summary of the proceedings from the Esophageal Diagnostic Working Group'. Together they form a unique fingerprint.

Cite this