Diagnosis of GERD in typical and atypical manifestations

Acta Biomed. 2018 Dec 17;89(8-S):33-39. doi: 10.23750/abm.v89i8-S.7963.


The manifestations of gastroesophageal reflux disease (GERD) have been recently classified into either esophageal or extra-esophageal syndromes. Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD. Endoscopy had a low sensitivity. Recently, the availability of multichannel intraluminal impedance and pH-monitoring (MII-pH) has modified the diagnostic approach towards atypical manifestations of GERD. There is a rising consensus that this technique should be considered as the gold standard for GERD diagnosis. Gastrin 17 (G-17) has been proposed as a non-invasive marker of GERD, due to the negative feedback between acid and the hormone. G17 levels seem able to identify patients with acid and non-acid reflux.

Publication types

  • Review

MeSH terms

  • Bilirubin / analysis
  • Body Fluids / chemistry
  • Chest Pain / diagnosis
  • Diagnosis, Differential
  • Electric Impedance
  • Esophageal pH Monitoring / methods
  • Gastrins / analysis
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / drug therapy
  • Humans
  • Manometry
  • Monitoring, Ambulatory
  • Proton Pump Inhibitors / therapeutic use
  • Symptom Assessment


  • Gastrins
  • Proton Pump Inhibitors
  • gastrin 17
  • Bilirubin