Patients with refractory gastroesophageal reflux disease: diagnostic tools

Abstract

Patients with refractory to proton pump inhibitors (PPIs) gastroesophageal reflux disease
(GERD) symptoms are approximately 40% and represent a very common problem in clinical
practice. Many of these patients do not have GERD, but suffer from functional heartburn or
hypersensitive esophagus. After thorough clinical evaluation and failure of escalation of PPI
dose, diagnostic investigations include endoscopy, esophageal manometry, pH testing, esophageal
Bilitec and esophageal impedance with pH monitoring.

Keywords Refractory GERD, diagnosis