Mistakes in gastro-oesophageal reflux disease diagnosis and how to avoid them

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Mistakes in gastro-oesophageal reflux disease diagnosis and how to avoid them

Francois Mion, Sabine Roman

Summary

AI Generated

Gastro-oesophageal reflux disease is a frequently encountered condition affecting quality of life, defined by troublesome symptoms or complications from stomach content reflux, with an estimated prevalence of around 24% in Europe.

According to the Montreal definition, GORD develops when reflux of stomach contents causes troublesome symptoms and/or complications.
Heartburn and regurgitation are typical symptoms of GORD, while chest pain, cough and sore throat are considered atypical symptoms, though none is pathognomonic.
GORD has an estimated prevalence of around 24% in Europe and accounts for $9 billion per year in healthcare costs in the US.
GORD has a negative effect on quality of life and is frequently encountered in clinical practice.

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Vakil N, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006; 101: 1900–1920. [Link]

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Peery AF, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 2012; 143: 1179–1187.e1-3. [Link]

Gatta L, et al. Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2007; 25: 385–392. [Link]

Herregods TV, et al. Patients with refractory reflux symptoms often do not have GERD. Neurogastroenterol Motil 2015; 27: 1267–1273. [Link]

Boeckxstaens GE, Zaninotto G and Richter JE. Achalasia. Lancet 2014; 383: 83–93. [Link]

Kessing BF, Bredenoord AJ and Smout AJ. Erroneous diagnosis of gastroesophageal reflux disease in achalasia. Clin Gastroenterol Hepatol 2011; 9: 1020–1024. [Link]

Gyawali CP, Yadlapati R, Fass R, Katzka D, Pandolfino J, Savarino E, Sifrim D, Spechler S, Zerbib F, Fox MR, Bhatia S, de Bortoli N, Cho YK, Cisternas D, Chen CL, Cock C, Hani A, Remes Troche JM, Xiao Y, Vaezi MF, Roman S.

Absah I, et al. Rumination syndrome: pathophysiology, diagnosis, and treatment. Neurogastroenterol Motil 2017; 29: e12954 . [Link]

10.

Absah I, et al. Rumination syndrome: pathophysiology, diagnosis, and treatment. Neurogastroenterol Motil 2017; 29: e12954 [Link]

11.

Zerbib F and Stoll D. Management of laryngopharyngeal reflux: an unmet medical need. Neurogastroenterol Motil 2010; 22: 109–112. [Link]

12.

Bytzer P, et al. Limited ability of the proton-pump inhibitor test to identify patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2012; 10: 1360–1366. [Link]

13.

Tenca A, et al. Gastro-esophageal reflux and antisecretory drugs use among patients with chronic autoimmune atrophic gastritis: a study with pH-impedance monitoring. Neurogastroenterol Motil 2016; 28: 274–280. [Link]

14.

Roman S, et al. Majority of symptoms in esophageal reflux PPI non-responders are not related to reflux. Neurogastroenterol Motil 2015; 27: 1667–1674. [Link]

15.

Kessing BF, Bredenoord AJ and Smout AJ. The pathophysiology, diagnosis and treatment of excessive belching symptoms. Am J Gastroenterol 2014; 109: 1199–1203. [Link]

16.

Molina-Infante J, et al. Proton pump inhibitor-responsive oesophageal eosinophilia: an entity challenging current diagnostic criteria for eosinophilic oesophagitis. Gut 2016; 65: 524–531. [Link]

17.

Lucendo AJ, et al.Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J 2017; 5: 335–358. [Link]

18.

Mion F, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obes Surg 2016; 26: 2449–2456. [Link]

Abstract

According to the Montreal definition, “[gastro-oesophageal reflux disease (GORD)] is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications.”1 GORD has a negative effect on quality of life and is frequently encountered in clinical practice, with an estimated prevalence of around 24% in Europe. In the US, GORD-related healthcare costs account for $9 billion per year. A variety of symptoms are associated with GORD—heartburn and regurgitation are typical symptoms, while chest pain, cough and sore throat are considered atypical symptoms—but none is pathognomonic

Topics

Neurogastroenterology & Motility Oesophagus

Citation

Roman S and Mion F. Mistakes in gastro-oesophageal reflux disease and how to avoid them. UEG Education 2017; 17: 24–26.

Published

2024

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