Reflux Monitoring Testing

The current state-of-the-art method for assessing gastroesophageal reflux (a.k.a. GERD) continues to be impedance combined pH monitoring.  While this does involve having a very fine sized tube placed into the nose and then into the esophagus, it offers the ability to find not only acid reflux, but nonacid reflux. 

Nonacid reflux accounts for about 40% of reflux not completely controlled by the usual acid lowering drugs; the most popular of which are the proton pump inhibitors.  More and more, we are realizing that the mechanical aspect of reflux related to dysfunction of the lower esophageal sphincter (LES) may be a better target for therapy when compared to acid control alone.  Drugs that will act on the LES function are on the horizon.  Additionally, the evolution of incisionless reflux surgery progresses.