Although our http://www.selleckchem.com/products/bmn-673.html insight has significantly increased over the past years, more studies are required to better understand symptom generation in GERD, especially in patients with therapy-resistant symptoms. David S. Estores There are problems with the definition, assessment, and measurement of gastroesophageal reflux disease (GERD). The Reflux Disease Questionnaire and the GERD questionnaire are patient-reported outcome (PRO) measures for use in a primary care

setting, which are easy to use and are validated. There is no widely accepted definition of a proton pump inhibitor test and performance of the test in the clinical setting is not standardized. The use of the PRO measures in primary care with predetermined cutoff values may help to reduce

the cost of diagnosing GERD and increasing rates of response for evaluated patients to acid suppression. Virender K. Sharma Endoscopy is commonly performed for the diagnosis and management of gastroesophageal reflux disease (GERD). Endoscopy allows the physician to evaluate esophageal mucosa for evidence of esophagitis and Barrett esophagus, to obtain mucosal biopsies for evaluation of such conditions as eosinophilic Tofacitinib esophagitis and diagnosis and grading of Barrett esophagus, and to apply various therapies. In a patient with suboptimal response to GERD therapy, endoscopy excludes other etiologies as a cause of patients’ symptoms. Newer endoscopic therapies for GERD are available or are in development. Advances in imaging techniques in development will improve the diagnostic yield of endoscopy and may replace the need for mucosal biopsies. Mark E. Baker and David M. Einstein The barium esophagram is an integral part of the assessment and management of

patients with gastroesophageal reflux disease (GERD) before, and especially after, antireflux procedures. While many of the findings on the examination can be identified with endosocopy, a gastric emptying study and an esophageal motility examination, the barium esophagram is better at demonstrating the anatomic findings after antireflux surgery, especially in symptomatic patients. These complementary examinations, when taken as a whole, fully evaluate a patient with suspected Thymidylate synthase GERD as well as symptomatic patients after antireflux procedures. Michael Mello and C. Prakash Gyawali High-resolution manometry (HRM) allows nuanced evaluation of esophageal motor function, and more accurate evaluation of lower esophageal sphincter (LES) function, in comparison with conventional manometry. Pathophysiologic correlates of gastroesophageal reflux disease (GERD) and esophageal peristaltic performance are well addressed by this technique. HRM may alter the surgical decision by assessment of esophageal peristaltic function and exclusion of esophageal outflow obstruction before antireflux surgery.