Importance of non-acidic reflux

Acid reflux clearly is injurious to the esophagus. What about non-acid reflux? As previously discussed, there are potentially injurious agents that can be refluxed other than acid, for example, bile. Esophageal acid testing accurately identifies acid reflux and has been extremely useful in studying the injurious effects of acid. Until recently, however, it has been impossible or difficult to accurately identify non-acid reflux and, therefore, to study whether or not non-acid reflux is injurious or can cause symptoms. A new technology allows the accurate determination of non-acid reflux. This technology uses the measurement of impedence changes within the esophagus to identify reflux of liquid, be it acid or non-acid. By combining measurement of impedence and ph it is possible to identify reflux and to tell if the reflux is acid or non-acid. It is too early to know how important non-acid reflux is in causing esophageal damage, symptoms, or complications, but there is little doubt that this new technology will be able to resolve the issues surrounding non-acid reflux.
GERD At A Glance

* GERD is a condition in which the acidified liquid contents of the stomach backs up into the esophagus.
* The causes of GERD include an abnormal lower esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and slow emptying of the stomach.
* GERD may damage the lining of the esophagus, thereby causing inflammation (esophagitis), although usually it does not.
* The symptoms of uncomplicated GERD are heartburn, regurgitation, and nausea.
* Complications of GERD include ulcers and strictures of the esophagus, Barrett's esophagus, cough and asthma, throat and laryngeal inflammation, inflammation and infection of the lungs, and collection of fluid in the sinuses and middle ear.
* Barrett's esophagus is a pre-cancerous condition that requires periodic endoscopic surveillance for the development of cancer.
* GERD may be diagnosed or evaluated by a trial of treatment, endoscopy, biopsy, x-ray, examination of the throat and larynx, 24 hour esophageal acid testing, esophageal motility testing, emptying studies of the stomach, and esophageal acid perfusion.
* GERD is treated with life-style changes, antacids, histamine antagonists (H2 blockers), proton pump inhibitors (PPIs), pro-motility drugs, foam barriers, surgery, and endoscopy.