Esophageal acid exposure is considered as pathological if acid exposure time (AET) is greater than 6% on pH testing. Recommendations are provided for data acquisition and analysis. In patients with a high probability of GERD (esophagitis grade C and D, histology proven Barrett's mucosa >1В cm, peptic stricture, previous positive pH monitoring) and persistent symptoms, pH-impedance monitoring should be performed on treatment. In this setting, testing can be either catheter-based or wireless pH-monitoring or pH-impedance monitoring. Key Results: Reflux testing should be performed after cessation of acid suppressive medication in patients with a low likelihood of GERD. Statements were proposed and discussed during several structured meetings. Methods: Literature search was focused on indications and technical recommendations for GERD testing and phenotypes definitions. Further testing should be considered when none of these criteria are fulfilled.ДЄbstract = 'Background: An international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro-esophageal reflux disease (GERD). Conclusions and Inferences: The consensus group determined that grade C or D esophagitis, peptic stricture, histology proven Barrett's mucosa >1В cm, and esophageal acid exposure greater >6% are sufficient to define pathological GERD. A positive symptom-reflux association in the absence of pathological AET defines hypersensitivity to reflux. Positive symptom reflux association is defined as symptom index (SI) >50% or symptom association probability (SAP) >95%. Number of reflux episodes and baseline impedance are exploratory metrics that may complement AET.

Background: An international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro-esophageal reflux disease (GERD).

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