REVIEW

Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux

D Sifrim¹, D Castell², J Dent³, P J Kahrilas⁴

¹ Centre for Gastroenterological Research, Faculty of Medicine, Catholic University of Leuven, Belgium
² Director, Esophageal Disorders Program, Medical University of South Carolina, Charleston, South Carolina, USA
³ Department of Gastroenterology, Hepatology, and General Medicine, Royal Adelaide Hospital, Adelaide, Australia
⁴ Division of Gastroenterology, Northwestern University’s Feinberg School of Medicine, Chicago, Illinois, USA

Correspondence to:
Correspondence to:
Dr D Sifrim
Faculty of Medicine, Lab Gastrointestinal Fysiopathology, O&N Gasthuisberg, 7th Floor, Herestraat 49, 3000 Leuven, Belgium; daniel.sifrim{at}med.kuleuven.ac.be

To date, most concepts on the frequency of gastro-oesophageal reflux episodes and the efficiency of the antireflux barrier have been based on inferences derived from measurement of oesophageal pH. The development of intraluminal impedance monitoring has highlighted the fact that pH monitoring does not detect all gastro-oesophageal reflux events when little or no acid is present in the refluxate, even if special pH tracing analysis criteria are used. In November 2002, a workshop took place at which 11 specialists in the field of gastro-oesophageal reflux disease discussed and criticised all currently available techniques for measurement of reflux. Here, a summary of their conclusions and recommendations of how to achieve the best results from the various techniques now available for reflux measurement is presented.

Abbreviations: GORD, gastro-oesophageal reflux disease; LOS, lower oesophageal sphincter; tLOSR, transient lower oesophageal sphincter relaxation; DGOR, duodenogastro-oesophageal reflux

Keywords: gastro-oesophageal reflux disease; acid reflux; non-acid reflux; gas reflux; oesophagitis; impedance

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