Diagnosis of gastro-oesophageal reflux disease and its associated conditions

Abstract

As the prevalence of gastro-oesophageal reflux disease (GORD) continues to rise, diagnostic modalities are crucial to differentiate GORD from related and overlapping conditions such as Barrett's oesophagus (BO), eosinophilic oesophagitis (EO) and jackhammer oesophagus (JO). Patient medical history and symptom assessment are critical in the diagnosis of GORD, and endoscopy should be utilized when patients present with alarming symptoms or are unresponsive to proton pump inhibitors. Ambulatory pH monitoring is the modality with the highest sensitivity and specificity; it is particularly helpful in unclear cases and during preoperative testing. BO is a consequence of GORD and a well-known preneoplastic condition; endoscopic evaluation is required. EO and JO are important overlapping conditions that should be differentiated when diagnosing GORD; JO is typically diagnosed using high-resolution manometry whereas EO is typically diagnosed by measuring rates of infiltrating eosinophils.