| [ Summary ] |
Some patients complain of reflux symptoms even when the presence of acidic conditions is not observed with 24-hour pH monitoring for gastroesophageal acid reflux. A possible cause of symptoms, occurring with non-acid reflux was studied. The invention of combined intra-esophageal 24-hour multi-channel impedance and pH monitoring studies made it possible to separate gastroesophageal reflux into three groups: acid reflux, pH<4.0; weakly acidic reflux,4.0<pH<7.0; non-acid reflux and reflux with 7.0<pH levels. The employment of this new system clarified the role of non-acid reflux in the pathogenesis of GERD. Proton pump inhibitor-resistant GERD incidence was considered to be limited. For the treatment of GERD, we should focus on acid levels and weakly acidic reflux instead of non-acid reflux. |