Modern diagnosis of GERD: the Lyon Consensus
- Gyawali, C. Prakash
- Kahrilas, Peter J.
- Savarino, Edoardo
- Zerbib, Frank
- Mion, Francois
- Smout, André 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's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance 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 monitoring ...
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