Modern diagnosis of GERD: the Lyon Consensus
- Gyawali, C Prakash
- Kahrilas, Peter J
- Savarino, Edoardo
- Zerbib, Frank
- Mion, Francois
- Smout, Andr\ue9 J P M
- Vaezi, Michael
- Sifrim, Daniel
- Fox, Mark R
- Vela, Marcelo F
- Tutuian, Radu
- Tack, Jan
- Bredenoord, Albert J
- Pandolfino, John
- Roman, Sabine
DOIAbstract
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett\u2019s mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pHimpedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors. Reflux-symptom association on ambulatory reflux monitor...
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