Importance of Esophageal Manometry and pH Monitoring in the Evaluation of Patients with Refractory Gastroesophageal Reflux Disease: A Multicenter Study

Abstract

The results of this study showed that (1) one-third of achalasia patients complained of heartburn and (2) patients with heartburn not responding to medical treatment must be carefully evaluated before referral to surgery. These data confirm the importance of esophageal manometry and pH monitoring in any patient considered for LARS.

Paraesophageal Hernia and Reflux Prevention: Is One Fundoplication Better than the Other?

“…The debate whether to add or not a fundoplication still persists. Proponents of the addition of a fundoplication cite that GER symptoms have poor sensitivity and specificity [13][14][15][16][17] and are unreliable when deciding whether to perform a fundoplication or not. A preoperative pH monitoring would be the most appropriate tool in this decision-making, as it provides a more sensitive and specific assessment of the presence and severity of GERD.…”

High-Pressure Tactics: Jackhammer Esophagus—Diagnosing Is Easier than Treating

“…This case highlights the difficulties encountered in the real-world management of patients who complain of overlap symptoms suggestive of both GERD and spastic esophageal motility disorders. Even patients with a manometrically diagnosed major esophageal motility disorder can initially manifest with predominant heartburn [1,2]. Therefore, a thorough clinical and functional assessment is mandatory for therapeutic decision-making.…”

Achalasia management: the South American viewpoint

“…[1] This rarity leads to frequent misdiagnosis as shown by high rate of patients with achalasia referred for antireflux surgery. [2] The two affirmatives that achalasia is rare and lacks an etiology; however, may not be true in South America. In this continent, a local diseaseChagas disease or American trypanosomiasis -caused by the inoculation of a parasite through a bug bite leads to an esophagopathy almost indistinguishable from idiopathic achalasia found in other continents, as shown in the paper by Dr. Dantas in this seminar.…”