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Review
. 2018 Dec 17;89(8-S):33-39.
doi: 10.23750/abm.v89i8-S.7963.

Diagnosis of GERD in typical and atypical manifestations

Silvia Cesario  1 , Serena Scida, Chiara Miraglia, Alberto Barchi, Antonio Nouvenne, Gioacchino Leandro, Tiziana Meschi, Gian Luigi De' Angelis, Francesco Di Mario
Affiliations
Review

Diagnosis of GERD in typical and atypical manifestations

Silvia Cesario et al. Acta Biomed. .

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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Figures

Figure 1.
Figure 1.
Median values of PSPW index and MNBI for the various diagnostic categories in the heartburn spectrum
Figure 2.
Figure 2.
Role of G-17 in the control of gastric acid secretion
See this image and copyright information in PMC

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