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Latin American consensus on diagnosis of gastroesophageal reflux disease
(2024)
Jorge A. Olmos
;
John E. Pandolfino
;
María M. Piskorz
;
Natalia Zamora
;
Miguel A. Valdovinos Díaz
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Diagnosing gastroesophageal reflux disease (GERD) can be challenging given varying symptom presentations, and complex multifactorial pathophysiology. The gold standard for GERD diagnosis is esophageal acid exposure time (AET) measured by pH‐metry. A variety of additional diagnostic tools are available. The goal of this consensus was to assess the individual merits of GERD diagnostic tools based on current evidence, and provide consensus recommendations following discussion and voting by experts.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This consensus was developed by 15 experts from nine countries, based on a systematic search of the literature, using GRADE (grading of recommendations, assessment, development and evaluation) methodology to assess the quality and strength of the evidence, and provide recommendations regarding the diagnostic utility of different GERD diagnosis tools, using AET as the reference standard.</jats:p></jats:sec><jats:sec><jats:title>Key Results</jats:title><jats:p>A proton pump inhibitor (PPI) trial is appropriate for patients with heartburn and no alarm symptoms, but nor for patients with regurgitation, chest pain, or extraesophageal presentations. Severe erosive esophagitis and abnormal reflux monitoring off PPI are clearly indicative of GERD. Esophagram, esophageal biopsies, laryngoscopy, and pharyngeal pH monitoring are not recommended to diagnose GERD. Patients with PPI‐refractory symptoms and normal endoscopy require reflux monitoring by pH or pH‐impedance to confirm or exclude GERD, and identify treatment failure mechanisms. GERD confounders need to be considered in some patients, pH‐impedance can identify supragrastric belching, impedance‐manometry can diagnose rumination.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Erosive esophagitis on endoscopy and abnormal pH or pH‐impedance monitoring are the most appropriate methods to establish a diagnosis of GERD. Other tools may add useful complementary information.</jats:p></jats:sec>
Scopus© Citations 5 1
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Updates to the modern diagnosis of GERD: Lyon consensus 2.0
(2023)
C Prakash Gyawali
;
Rena Yadlapati
;
Ronnie Fass
;
David Katzka
;
John Pandolfino
<jats:p>The Lyon Consensus provides conclusive criteria for and against the diagnosis of gastro-oesophageal reflux disease (GERD), and adjunctive metrics that consolidate or refute GERD diagnosis when primary criteria are borderline or inconclusive. An international core and working group was assembled to evaluate research since publication of the original Lyon Consensus, and to vote on statements collaboratively developed to update criteria. The Lyon Consensus 2.0 provides a modern definition of actionable GERD, where evidence from oesophageal testing supports revising, escalating or personalising GERD management for the symptomatic patient. Symptoms that have a high versus low likelihood of relationship to reflux episodes are described. Unproven versus proven GERD define diagnostic strategies and testing options. Patients with no prior GERD evidence (unproven GERD) are studied using prolonged wireless pH monitoring or catheter-based pH or pH-monitoring off antisecretory medication, while patients with conclusive GERD evidence (proven GERD) and persisting symptoms are evaluated using pH-impedance monitoring while on optimised antisecretory therapy. The major changes from the original Lyon Consensus criteria include establishment of Los Angeles grade B oesophagitis as conclusive GERD evidence, description of metrics and thresholds to be used with prolonged wireless pH monitoring, and inclusion of parameters useful in diagnosis of refractory GERD when testing is performed on antisecretory therapy in proven GERD. Criteria that have not performed well in the diagnosis of actionable GERD have been retired. Personalisation of investigation and management to each patient’s unique presentation will optimise GERD diagnosis and management.</jats:p>
15Scopus© Citations 485
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Validation and psychometric evaluation of the Spanish version of Brief Esophageal Dysphagia Questionnaire (BEDQ): Results of a multicentric study
(2020)
CISTERNAS, DANIEL
;
Tiffany Taft
;
Dustin A. Carlson
;
GLASINOVIC VERNON, ESTEBAN ANDRES
;
Hugo Monrroy
1 1Scopus© Citations 5
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Esophagogastric junction morphology and contractile integral on high‐resolution manometry in asymptomatic healthy volunteers: An international multicenter study
(2020)
Benjamin D. Rogers
;
Arvind Rengarajan
;
Luiz Abrahao
;
Shobna Bhatia
;
Serhat Bor
Scopus© Citations 14 2
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The Spanish version of the esophageal hypervigilance and anxiety score shows strong psychometric properties: Results of a large prospective multicenter study in Spain and Latin America
(2021)
CISTERNAS, DANIEL
;
Tiffany Taft
;
Dustin A. Carlson
;
GLASINOVIC VERNON, ESTEBAN ANDRES
;
Hugo Monrroy
1Scopus© Citations 5 3
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Fair reliability of eckardt scores in achalasia and non‐achalasia patients: Psychometric properties of the eckardt spanish version in a multicentric study
(2020)
CISTERNAS, DANIEL
;
Hugo Monrroy
;
Arnoldo Riquelme
;
Oslando Padilla
;
Eduardo Fuentes‐López
Scopus© Citations 5 2 1
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Ineffective esophageal motility and bolus clearance. A study with combined high‐resolution manometry and impedance in asymptomatic controls and patients
(2020)
Frank Zerbib
;
Ingrid Marin
;
CISTERNAS, DANIEL
;
Luiz Abrahao
;
Albis Hani
18 1Scopus© Citations 29
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High-Resolution Manometry Thresholds and Motor Patterns Among Asymptomatic Individuals
(2022)
Arvind Rengarajan
;
Benjamin D. Rogers
;
Zhiqin Wong
;
Salvatore Tolone
;
Daniel Sifrim
30 1Scopus© Citations 33
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Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0
<sup>©</sup>
(2020)
Rena Yadlapati
;
Peter J. Kahrilas
;
Mark R. Fox
;
Albert J. Bredenoord
;
C. Prakash Gyawali
1Scopus© Citations 828 1
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Breaks in peristaltic integrity predict abnormal esophageal bolus clearance better than contraction vigor or residual pressure at the esophagogastric junction
(2021)
Benjamin D. Rogers
;
CISTERNAS, DANIEL
;
Arvind Rengarajan
;
Ingrid Marin
;
Luiz Abrahao
1Scopus© Citations 4 1

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