Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups.

Background: Patients with nonerosive reflux disease (NERD) have the lowest esophageal acid exposure profile compared with the other gastroesophageal reflux disease (GERD) groups.

Aim: To compare lower esophageal acid exposure recordings 1 cm above the lower esophageal sphincter (LES) with those 6 cm above the LES as well as to determine the characteristics of esophageal acid exposure along the esophagus among the different GERD groups.

Methods: Patients with classic heartburn symptoms were enrolled into the study.

Functional heartburn patients demonstrate traits of functional bowel disorder but lack a uniform increase of chemoreceptor sensitivity to acid.

Background: Functional heartburn (FH) patients have a profound impact on the response to anti-reflux therapy of the nonerosive reflux disease (NERD) group as compared to the response of the erosive esophagitis group. Thus far, there is paucity of information about their physiological and clinical characteristics that may separate them from the other NERD patients.

Aim: To compare physiological and clinical characteristics of patients with FH to their counterparts within the NERD group (NERD-positive [NERD+]).

Noncardiac chest pain: the role of the cardiologist--a national survey.

Background: The current assumption is that noncardiac chest pain (NCCP) patients diagnosed by a cardiologist are commonly referred to a gastroenterologist for further evaluation. Thus far, there are no studies that assess the clinical approach and referral patterns of cardiologists when evaluating subjects with NCCP.

Aim: To determine the extent of involvement of cardiologists in the management of NCCP patients.

The value of ambulatory 24 hr esophageal pH monitoring in clinical practice in patients who were referred with persistent gastroesophageal reflux disease (GERD)-related symptoms while on standard dose anti-reflux medications.

To determine the value of pH testing in clinical practice in gastroesophageal reflux disease patients who failed anti-reflux treatment. Patients resistant to standard dose proton pump inhibitor or an H2-blocker underwent pH testing. Randomly selected patients from the proton pump inhibitor failure group underwent the modified acid perfusion test as compared to patients with non-erosive reflux disease.

Attitudes and referral patterns of primary care physicians when evaluating subjects with noncardiac chest pain--a national survey.

Noncardiac chest pain (NCCP) may affect up to 23% of the U.S. population.

Treatment of gastroesophageal reflux disease.

Therapeutic modalities for gastroesophageal reflux disease (GERD) continue to evolve despite the introduction of proton pump inhibitors (PPIs), the most successful antireflux class of drugs. On-demand modalities such as antacids and alginates as well as histamine type-2 receptor antagonists continue to be popular with GERD patients who seek temporary relief of symptoms. The PPIs have revolutionized the treatment of patients with severe erosive esophagitis, complications of GERD, and atypical or extraesophageal manifestations of GERD.