Prolonged acid reflux monitoring using acid exposure time and DeMeester score: two days are not enough.

Background: Wireless pH monitoring allows for a definitive GERD diagnosis, which is essential for optimal medical or surgical management of the patient. However, there is no guideline recommendation on whether prolonged pH testing (72 or 96 h) provides additional benefit when compared to the standard 48-h testing. We aimed to assess whether prolonged pH monitoring diagnoses more patients with GERD, as well as compare the DeMeester score to acid exposure time as diagnostic criteria for GERD.

Virtual Reality for Pain Management During High-Resolution Manometry: A Randomized Clinical Trial.

Objective: High-resolution esophageal manometry (HRM) is the gold standard for the diagnosis of esophageal motility disorders. HRM is typically performed in the office with local anesthesia only, and many patients find it unpleasant and painful. The aim of this study was to examine the effects of the use of a virtual reality (VR) headset on pain and anxiety outcomes in patients with dysphagia undergoing HRM.

Gastrointestinal endometriosis causing subacute intestinal obstruction with gradual development of weight loss and misdiagnosed as irritable bowel syndrome.

Both endometriosis and irritable bowel syndrome (IBS) are commonly found in young women and the diagnosis of either is challenging. Alarm symptoms can exclude the diagnosis of IBS, but their onset may be insidious and often no evidence of organic disease may be found. We present a patient with a 4-year history of presumed IBS, absent gynecological symptoms, negative gastrointestinal as well as gynecological testing who developed the only alarm symptom of weight loss and was eventually found to have endometriosis of the small intestine.

Reflux and acid peptic diseases in the elderly.

Gastroesophageal reflux disease (GERD) is a common disorder among elderly patients seeking medical care. Diagnosis and management of GERD in the older patient is a unique challenge for both the primary care provider and the gastroenterologist. Such patients may have atypical symptoms, more severe disease, and a higher rate of complications such as erosive esophagitis, Barrett esophagus, and esophageal cancer.