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Evaluation of gastroesophageal reflux disease

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Abstract

Patients with gastroesophageal reflux disease (GERD) may present with a variety of symptoms, including heartburn, regurgitation, dysphagia, chronic cough, laryngitis, or even asthma. Therefore, the clinical presentation of GERD varies among individuals and conversely symptoms not always correspond to the presence of actual reflux. For that reason, the diagnosis poses certain challenges to the physician. To overcome these challenges, a thorough clinical examination followed by objective functional testing could improve diagnostic accuracy. In addition, a proper evaluation of patients with GERD can help in identifying those who will likely benefit the most from an antireflux procedure. The diagnostic work-up of these patients should include: symptomatic evaluation, upper endoscopy, barium swallow, high-resolution manometry, and ambulatory pH monitoring. Once a proper diagnosis of GERD is achieved, antireflux surgery is an excellent option for patients with partial control of symptoms with medication, for patients who do not want to be on long-term medical treatment (compliance/cost), or when complications of medical treatment occur.

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References

  1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus G (2006) The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 101(8):1900–1920 (quiz 43)

    Article  PubMed  Google Scholar 

  2. Katz PO, Gerson LB, Vela MF (2013) Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 108(3):308–328 (quiz 29)

    Article  PubMed  Google Scholar 

  3. Patti MG, Diener U, Tamburini A, Molena D, Way LW (2001) Role of esophageal function tests in diagnosis of gastroesophageal reflux disease. Dig Dis Sci 46(3):597–602

    Article  CAS  PubMed  Google Scholar 

  4. Andolfi C, Bonavina L, Kavitt RT, Konda VJ, Asti E, Patti MG (2016) Importance of esophageal manometry and pH monitoring in the evaluation of patients with refractory gastroesophageal reflux disease: a multicenter study. J Laparoendosc Adv Surg Tech A 26(7):548–550

    Article  PubMed  Google Scholar 

  5. Jobe BA, Richter JE, Hoppo T, Peters JH, Bell R, Dengler WC et al (2013) Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the esophageal diagnostic advisory panel. J Am Coll Surg 217(4):586–597

    Article  PubMed  Google Scholar 

  6. Shaw M, Dent J, Beebe T, Junghard O, Wiklund I, Lind T et al (2008) The Reflux Disease Questionnaire: a measure for assessment of treatment response in clinical trials. Health Qual Life Outcomes 6:31

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ducrotte P, Zerbib F (2007) ReQuest: a new questionnaire for the simultaneous evaluation of symptoms and well-being in patients with gastro-oesophageal reflux. Digestion 75(Suppl 1):79–86

    Article  PubMed  Google Scholar 

  8. Campos GM, Peters JH, DeMeester TR, Oberg S, Crookes PF, Tan S et al (1999) Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg 3(3):292–300

    Article  CAS  PubMed  Google Scholar 

  9. Bello B, Zoccali M, Gullo R, Allaix ME, Herbella FA, Gasparaitis A et al (2013) Gastroesophageal reflux disease and antireflux surgery-what is the proper preoperative work-up? J Gastrointest Surg 17(1):14–20

    Article  PubMed  Google Scholar 

  10. Andolfi C, Plana A, Furno S, Fisichella PM (2017) Paraesophageal hernia and reflux prevention: is one fundoplication better than the other? World J Surg 41(10):2573–2582

    Article  PubMed  Google Scholar 

  11. Andolfi C, Vigneswaran Y, Kavitt RT, Herbella FA, Patti MG (2017) Laparoscopic antireflux surgery: importance of patient’s selection and preoperative workup. J Laparoendosc Adv Surg Tech A 27(2):101–105

    Article  PubMed  Google Scholar 

  12. Fisichella PM, Jalilvand A (2014) The role of impaired esophageal and gastric motility in end-stage lung diseases and after lung transplantation. J Surg Res 186(1):201–206

    Article  PubMed  Google Scholar 

  13. Sidhwa F, Moore A, Alligood E, Fisichella PM (2017) Diagnosis and treatment of the extraesophageal manifestations of gastroesophageal reflux disease. Ann Surg 265(1):63–67

    Article  PubMed  Google Scholar 

  14. Lord RV, Kaminski A, Oberg S, Bowrey DJ, Hagen JA, DeMeester SR et al (2002) Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg 6(1):3–9 (discussion 10)

    Article  PubMed  Google Scholar 

  15. Herbella FA, Andolfi C, Vigneswaran Y, Patti MG, Pinna BR (2016) Importance of esophageal manometry and pH monitoring for the evaluation of otorhinolaryngologic (ENT) manifestations of GERD. A multicenter study. J Gastrointest Surg 20(10):1673–1678

    Article  PubMed  Google Scholar 

  16. Bredenoord AJ, Weusten BL, Smout AJ (2005) Symptom association analysis in ambulatory gastro-oesophageal reflux monitoring. Gut 54(12):1810–1817

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Desjardin M, Luc G, Collet D, Zerbib F (2016) 24-hour pH-impedance monitoring on therapy to select patients with refractory reflux symptoms for antireflux surgery. A single center retrospective study. Neurogastroenterol Motil 28(1):146–152

    Article  CAS  PubMed  Google Scholar 

  18. Galindo G, Vassalle J, Marcus SN, Triadafilopoulos G (2013) Multimodality evaluation of patients with gastroesophageal reflux disease symptoms who have failed empiric proton pump inhibitor therapy. Dis Esophagus 26(5):443–450

    Article  CAS  PubMed  Google Scholar 

  19. Weinstein DH, deRijke S, Chow CC, Foruraghi L, Zhao X, Wright EC et al (2013) A new method for determining gastric acid output using a wireless pH-sensing capsule. Aliment Pharmacol Ther 37(12):1198–1209

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Pandolfino JE, El-Serag HB, Zhang Q, Shah N, Ghosh SK, Kahrilas PJ (2006) Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 130(3):639–649

    Article  PubMed  Google Scholar 

  21. El-Serag HB, Graham DY, Satia JA, Rabeneck L (2005) Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 100(6):1243–1250

    Article  PubMed  Google Scholar 

  22. Viscido G, Gorodner V, Signorini F, Navarro L, Obeide L, Moser F (2018) Laparoscopic sleeve gastrectomy: endoscopic findings and gastroesophageal reflux symptoms at 18-month follow-up. J Laparoendosc Adv Surg Tech A 28(1):71–77

    Article  PubMed  Google Scholar 

  23. Coupaye M, Gorbatchef C, Calabrese D, Sami O, Msika S, Coffin B et al (2018) Gastroesophageal reflux after sleeve gastrectomy: a prospective mechanistic study. Obes Surg 28(3):838–845

    Article  PubMed  Google Scholar 

  24. Patti MG, Fisichella PM, Perretta S (2001) Preoperative evaluation of patients with gastroesophageal reflux disease. J Laparoendosc Adv Surg Tech A 11(6):327–331

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Boston VAMC, Boston, MA, USA

    Piero Marco Fisichella

  2. Department of Surgery, Hospital Alemán of Buenos Aires, University of Buenos Aires, Buenos Aires, Argentina

    Francisco Schlottmann

  3. Department of Medicine and Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Francisco Schlottmann & Marco G. Patti

  4. University of North Carolina at Chapel Hill, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA

    Francisco Schlottmann

Authors
  1. Piero Marco Fisichella
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  2. Francisco Schlottmann
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  3. Marco G. Patti
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Correspondence to Francisco Schlottmann.

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Piero Marco Fisichella declares that he has no conflict of interest. Francisco Schlottmann declares that he has no conflict of interest. Marco G. Patti declares that he has no conflict of interest.

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This study does not contain any studies with human participants performed by any of the authors.

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Fisichella, P.M., Schlottmann, F. & Patti, M.G. Evaluation of gastroesophageal reflux disease. Updates Surg 70, 309–313 (2018). https://doi.org/10.1007/s13304-018-0563-z

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  • DOI: https://doi.org/10.1007/s13304-018-0563-z

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