Non-erosive gastroesophageal reflux disease determination criteria by functional tests: a predictive model based on multivariate analysis

Background: Gastroesophageal reflux disease (GERD) in 2009 presented a prevalence of 11.5% in Venezuela. It is a complex, multifactorial disease that is difficult to define, since it consists of several signs and symptoms that may or may not coexist together, both in the presence and absence of the disease.Methods: A prospective study was conducted that consisted of a group of 85 patients diagnosed with non-erosive gastroesophageal reflux disease (NERD) and 20 asymptomatic volunteers. Functional tests were conducted on both groups that included high resolution manometry, 24-hour pH-metry - impedance study. The chi-square independence test, principal component analysis and multiple correspondence analysis were applied to identify which variables showed greater association and importance for the diagnosis of NERD.Results: The results indicated that it is possible to establish a rapid diagnostic test based on the solid drink test, distal contraction index, peristaltic jumps and presence of heartburn with a sensitivity of 96% and specificity of 90%.Conclusions: It is possible to establish a NERD rapid diagnostic test based on functional tests.

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High-resolution Manometry in Patients with Gastroesophageal Reflux Disease Before and After Fundoplication

Journal of Neurogastroenterology and Motility ◽

10.5056/jnm16062 ◽

2017 ◽

Vol 23 (1) ◽

pp. 55-63 ◽

Cited By ~ 11

Author(s):

Katarzyna Rerych ◽

Józef Kurek ◽

Ewa Klimacka-Nawrot ◽

Barbara Błońska-Fajfrowska ◽

Antoni Stadnicki

Keyword(s):

High Resolution ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

High Resolution Manometry ◽

Before And After

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REACTION TO ARTICLES ON HIGH RESOLUTION MANOMETRY, THE LENGTH OF THE LOWER ESOPHAGEAL SPHINCTER AND THE DIAGNOSIS OF GASTROESOPHAGEAL REFLUX DISEASE

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-39 ◽

2019 ◽

Vol 56 (2) ◽

pp. 209-210

Author(s):

Michael D LEVIN

Keyword(s):

High Resolution ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Lower Esophageal Sphincter ◽

Reflux Disease ◽

High Resolution Manometry ◽

Esophageal Sphincter

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Efficacy and Safety of Robotic Dor Fundoplication on Severe Gastroesophageal Reflux Disease in Patients With Scleroderma

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211051211 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110512

Author(s):

Priyadarshini Loganathan ◽

Mahesh Gajendran ◽

Brian Davis ◽

Richard McCallum

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Surgical Complication ◽

Smooth Muscles ◽

Dor Fundoplication ◽

High Resolution Manometry ◽

Refractory Gerd ◽

Significant Impairment ◽

Gerd Symptoms

Systemic sclerosis (SSc) is a disease that affects the gastrointestinal tract resulting in its atrophy and fibrosis of smooth muscles. Approximately 80% of SSc patients develop both gastroesophageal reflux disease (GERD) and dysphagia. The nocturnal GERD can cause regurgitation and aspiration, which can further aggravate the pulmonary fibrosis from SSc. Also, their dysphagia is further worsened by performing standard Nissen fundoplication. Therefore, we aimed to investigate whether Dor fundoplication (a 180° anterior wrap) can reduce nocturnal heartburn and regurgitation without worsening dysphagia in patients with SSc and severe GERD. Five SSc patients with drug-refractory severe GERD underwent a Dor fundoplication procedure with a median follow-up of 2 years (range: 1-5 years). In all 5 patients, the preoperative high-resolution manometry showed significant impairment of esophageal motility. Patients were interviewed postoperatively to assess for nocturnal and diurnal GERD symptoms, treatment response, the status of dysphagia, and adverse effects of surgery. The average age of 5 patients was 50 years and all were females. Four of the 5 patients (80%) reported 90% improvement in both diurnal and nocturnal GERD symptoms since surgery, with no nocturnal reflux, heartburn, or regurgitation, and reports to sleep at night without requiring any more pillows or wedges. About 50% of patients reported a decrease in their proton pump inhibitor dosage after surgery compared to before surgery. No surgical complication was reported and specifically, no worsening of dysphagia. The Dor fundoplication performed for refractory GERD in SSc patients substantially decreases heartburn and regurgitation, primarily nocturnal, without affecting dysphagia, thus improving the quality of life.

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