University Emergency Hospital Bucharest, Gastroenterology Department, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy,Bucharest, Romania.
Rom J Intern Med. 2021 Mar 5;59(1):3-9. doi: 10.2478/rjim-2020-0027. Print 2021 Mar 1.
Gastroesophageal reflux disease (GERD) is considered one of the most frequent chronic gastrointestinal diseases globally with high costs due to treatment and investigations.First line therapy is with proton pump inhibitors, those who do not respond to initial treatment usually require further investigations such as upper gastrointestinal endoscopy or ambulatory 24-hours esophageal pH monitoring. The total time of exposure to acid and the DeMeester score represent the most useful parameters associated with conventional pH-metry, because they can identify gastroesophageal reflux disease.Although pH-metry is considered the gold standard for the evaluation of gastroesophageal reflux disease, new impedance-based parameters have been introduced in recent years with the role of increasing the accuracy of diagnosing gastroesophageal reflux disease and characterizing the type of reflux. The development of multichannel intraluminal pH-impedance has improved the ability to detect and quantify gastroesophageal reflux. New parameters such as post-reflux swallowing peristaltic wave (PSPW) index and the mean nocturnal basal impedance (MNBI) have recently been introduced to assess GERD phenotypes more accurately. This review evaluates current GERD diagnotic tools while also taking a brief look at newer diagnostic parameters like PSPW and MNBI.
胃食管反流病（GERD）被认为是全球最常见的慢性胃肠道疾病之一，由于治疗和检查费用高昂。一线治疗是质子泵抑制剂，那些对初始治疗没有反应的人通常需要进一步的检查，如上消化道内窥镜检查或 24 小时食管 pH 监测。暴露于酸的总时间和 DeMeester 评分是与常规 pH 测定最相关的有用参数，因为它们可以识别胃食管反流病。尽管 pH 测定被认为是胃食管反流病评估的金标准，但近年来已经引入了基于阻抗的新参数，其作用是提高胃食管反流病诊断的准确性并确定反流类型。多通道腔内 pH-阻抗的发展提高了检测和量化胃食管反流的能力。最近引入了新的参数，如反流后吞咽蠕动波（PSPW）指数和平均夜间基础阻抗（MNBI），以更准确地评估 GERD 表型。这篇综述评估了当前的 GERD 诊断工具，同时也简要介绍了新的诊断参数，如 PSPW 和 MNBI。
