Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 8: Mr. Jones Has Classic Reflux Symptoms Even While Taking Bid Esomeprazole. I Have Considered A Ph Probe With Impedance To Document Non-Acid Reflux, But I Am Wondering What Therapy I Can Provide Even If This Test Is Conclusive? (continued)

The availability of combined multichannel intraluminal impedance (MII) pH monitoring has added to our ability to evaluate patients with symptoms suspected due to GERD refractory to antisecretory therapy. This technology allows the assessment of both acid (pH) and non-acid (impedance) reflux. A series of studies with this technology evaluating patients with symptoms suggestive of reflux on proton pump inhibitor therapy have documented the presence of non-acid reflux and their association with symptoms. Thus if in the judgment of the clinician, the patient has symptoms caused by non-acid…