What To Do If... ?
Filippo Torroni, Paola De angelis, Tamara Caldaro, Erminia Romeo, Francesca Rea, Simona Faraci, Luigi Dall’Oglio
1Unità Operativa Complessa di Chirurgia Endoscopica Digestiva, Ospedale Pediatrico Bambino Gesù IRCCS di Roma
Patients with GERD refractory to PPI treatment requiring more investigation to achieve the diagnosis: impedance- pH monitoring, upper gastrointestinal endoscopy with biopsy should be performed to exclude other gastrointestinal disorders. Impedance-pH monitoring is the most useful diagnostic test to establish a cause- and-effect relationship between persistent symptoms and reflux; upper endoscopy to detect eosinophilic esophagitis or infectious esophagitis. Manometry is a noninvasive diagnostic tool for identifying motility dysfunction of the gastrointestinal tract.