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After 3 and 6 months of PPI-therapy significant decreases in the RSI were found. The functional endoscopy characteristics which were expected to remain constant were controlled after 6 months and found to be nearly 100 % reproducible. Patients profit from PPI- therapy when reflux is detected by endoscopy even when RSI was initally normal. Functional endoscopy seems to be a useful instrument to detect extraesophageal reflux.

Classic gastroenterological diagnostic tools are proving increasingly insufficient for analyzing the complex causal relationship between extra-esophageal symptoms and presumed pathological reflux activity. Some new methodological approaches, such as functional endoscopy (videopanendoscopy, VPE), are considered to be helpful. However, there are currently no data objectively verifying the usefulness of this method. In a pilot study, a good correlation between the reflux symptom index (RSI) and endoscopic findings was shown. Impedance-pH measurement is considered to be the "gold standard" in esophageal reflux disease diagnostics. Therefore, the relationship between endoscopic findings and the results of impedance-pH monitoring are now studied in patients with extra-esophageal reflux symptoms. The investigation demonstrates that the pathological findings of VPE correlate well with impedance-pH measurements in terms of the parameters "number of reflux episodes", "fraction time", and "DeMeester score".

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