@article{9f20c2afea374dcb848be3898136cd55,
title = "Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group",
abstract = "Background: An international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro-esophageal reflux disease (GERD). Methods: Literature search was focused on indications and technical recommendations for GERD testing and phenotypes definitions. Statements were proposed and discussed during several structured meetings. Key Results: Reflux testing should be performed after cessation of acid suppressive medication in patients with a low likelihood of GERD. In this setting, testing can be either catheter-based or wireless pH-monitoring or pH-impedance monitoring. In patients with a high probability of GERD (esophagitis grade C and D, histology proven Barrett's mucosa >1 cm, peptic stricture, previous positive pH monitoring) and persistent symptoms, pH-impedance monitoring should be performed on treatment. Recommendations are provided for data acquisition and analysis. Esophageal acid exposure is considered as pathological if acid exposure time (AET) is greater than 6% on pH testing. Number of reflux episodes and baseline impedance are exploratory metrics that may complement AET. Positive symptom reflux association is defined as symptom index (SI) >50% or symptom association probability (SAP) >95%. A positive symptom-reflux association in the absence of pathological AET defines hypersensitivity to reflux. Conclusions and Inferences: The consensus group determined that grade C or D esophagitis, peptic stricture, histology proven Barrett's mucosa >1 cm, and esophageal acid exposure greater >6% are sufficient to define pathological GERD. Further testing should be considered when none of these criteria are fulfilled.",
keywords = "Gastro-esophageal reflux disease, esophageal acid exposure, esophagitis, reflux monitoring",
author = "{the GERD consensus group} and S. Roman and Gyawali, {C. P.} and E. Savarino and R. Yadlapati and F. Zerbib and J. Wu and M. Vela and R. Tutuian and R. Tatum and D. Sifrim and J. Keller and M. Fox and Pandolfino, {J. E.} and Bredenoord, {A. J.} and Fernando Azpiroz and Arash Babaei and Shobna Bhatia and Guy Boeckxstaens and Serhat Bor and Dustin Carlson and Donald Castell and Michele Cicala and John Clarke and {De Bortoli}, Nicola and Vasile Drug and Marzio Frazzoni and Richard Holloway and Peter Kahrilas and Arne Kandulski and Phil Katz and David Katzka and Ravinder Mittal and Francois Mion and Luis Novais and Amit Patel and Roberto Penagini and Mentore Ribolsi and Joel Richter and Renato Salvador and Vincenzo Savarino and Jordi Serra and Felice Schnoll-Sussman and Andre Smout and Edy Soffer and Rami Sweis and Jan Tack and Salvatore Tolone and Michael Vaezi and Philip Woodland and Yinglian Xiao",
note = "Funding Information: SR has served as consultant for Sandhill Scientific and Medtronic. CPG has served as a consultant for Medtronic and Torax, and has received research funding from Medtronic. ES has served as consultant for Medtronic, Abbvie, Takeda, Otsuka, Malesci. RY none. FZ Consultant Allergan, Reckitt Benckiser, Research funding: Medtronic, Sandhill Scientific. JW none to declare. MV Consultant: Medtronic, Torax, Sandhill Scientific. RTu none to declare. RTa none. DS has received research grants from Sandhill Scientific and Reckkit Benckiser. JK has served as a consultant for Medtronic and for Standard Instruments, and has received research funding. MF Consultant and speaker: Given Imaging, Reckitt Benckiser and Shire Pharmaceuticals. Research funding: Given Imaging, Mui Scientific, Reckitt Benckiser, Astra Zeneca and Nestle. Educational activities: Given Imaging, Sandhill Scientific Instruments and Medical Measurement Systems. JEP has as consultant and speaker for Medtonic and Sndhill, as speaker for Takeda and Astra Zeneca and as consultant for Ironwook and Impleo. AJB has served as a consultant for Medical Measurement Systems and has received research funding from Medtronic and Medical Measurement Systems. Funding Information: was supported by the Working Group for Gastrointestinal Motility Funding Information: The consensus process was supported by the Working Group for Gastrointestinal Motility and Function. This group received an educational grant of United European Gastroenterology (UEG). Publisher Copyright: {\textcopyright} 2017 John Wiley & Sons Ltd",
year = "2017",
month = oct,
doi = "10.1111/nmo.13067",
language = "English (US)",
volume = "29",
pages = "1--15",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",
number = "10",
}