Advances in diagnosing GERD: Which examinations should be performed before interventional therapy?

Summary Background This article aims to summarize the current technology available for evaluating esophageal function and gastroesophageal reflux disease (GERD), and to assess which of these examinations are necessary before antireflux surgery. Methods The Medline database was queried to identify relevant published information. Results Esophageal function testing is a useful adjunct to confirm or reject the diagnosis of GERD. Emerging technologies and new diagnostic methods may provide a better sensitivity in diagnosing GERD symptoms and could help in finding the right treatment for each patient. However, studies are needed to prove that these new tests truly add essential information. Conclusion Of the current available methods to identify the right treatment for each patient with symptoms of GERD, ambulatory reflux monitoring is still the most important one. Optimal preoperative diagnostic work-up for GERD should include pH testing along with upper endoscopy, barium esophagram, and manometry.