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Non-acid Reflux: When It Matters and Approach to Management.
Curr Gastroenterol Rep. 2020 Jul 10; 22(9):43.CG

Abstract

PURPOSE OF REVIEW

This narrative review focuses on the presentation, contributing factors, diagnosis, and treatment of non-acid reflux. We also propose algorithms for diagnosis and treatment.

RECENT FINDINGS

There is a paucity of recent data regarding non-acid reflux. The recent Porto and Lyon consensus statements do not fully address non-acid reflux or give guidance on classification. However, recent developments in the lung transplantation field, as well as older data in the general population, argue for the importance of non-acid reflux. Extrapolating from the Porto and Lyon consensus, we generally classify pathologic non-acid reflux as impedance events > 80, acid exposure time < 4%, and positive symptom correlation on a standard 24-h pH/impedance test. Other groups not meeting this criteria also deserve consideration depending on the clinical situation. Potential treatments include lifestyle modification, increased acid suppression, alginates, treatment of esophageal hypersensitivity, baclofen, buspirone, prokinetics, and anti-reflux surgery in highly selected individuals. More research is needed to clarify appropriate classification, with subsequent focus on targeted treatments.

Authors+Show Affiliations

Stanford Multidimensional Program for Innovation and Research in the Esophagus (S-MPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor, GI suite, Redwood City, CA, 94063, USA. zikosta@stanford.edu.Stanford Multidimensional Program for Innovation and Research in the Esophagus (S-MPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor, GI suite, Redwood City, CA, 94063, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32651702

Citation

Zikos, Thomas A., and John O. Clarke. "Non-acid Reflux: when It Matters and Approach to Management." Current Gastroenterology Reports, vol. 22, no. 9, 2020, p. 43.
Zikos TA, Clarke JO. Non-acid Reflux: When It Matters and Approach to Management. Curr Gastroenterol Rep. 2020;22(9):43.
Zikos, T. A., & Clarke, J. O. (2020). Non-acid Reflux: When It Matters and Approach to Management. Current Gastroenterology Reports, 22(9), 43. https://doi.org/10.1007/s11894-020-00780-4
Zikos TA, Clarke JO. Non-acid Reflux: when It Matters and Approach to Management. Curr Gastroenterol Rep. 2020 Jul 10;22(9):43. PubMed PMID: 32651702.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-acid Reflux: When It Matters and Approach to Management. AU - Zikos,Thomas A, AU - Clarke,John O, Y1 - 2020/07/10/ PY - 2020/7/12/entrez PY - 2020/7/12/pubmed PY - 2020/7/12/medline KW - Alginate KW - Anti-reflux surgery KW - Baclofen KW - Gastroesophageal reflux disease KW - Lung transplantation KW - Non-acid reflux SP - 43 EP - 43 JF - Current gastroenterology reports JO - Curr Gastroenterol Rep VL - 22 IS - 9 N2 - PURPOSE OF REVIEW: This narrative review focuses on the presentation, contributing factors, diagnosis, and treatment of non-acid reflux. We also propose algorithms for diagnosis and treatment. RECENT FINDINGS: There is a paucity of recent data regarding non-acid reflux. The recent Porto and Lyon consensus statements do not fully address non-acid reflux or give guidance on classification. However, recent developments in the lung transplantation field, as well as older data in the general population, argue for the importance of non-acid reflux. Extrapolating from the Porto and Lyon consensus, we generally classify pathologic non-acid reflux as impedance events > 80, acid exposure time < 4%, and positive symptom correlation on a standard 24-h pH/impedance test. Other groups not meeting this criteria also deserve consideration depending on the clinical situation. Potential treatments include lifestyle modification, increased acid suppression, alginates, treatment of esophageal hypersensitivity, baclofen, buspirone, prokinetics, and anti-reflux surgery in highly selected individuals. More research is needed to clarify appropriate classification, with subsequent focus on targeted treatments. SN - 1534-312X UR - https://www.unboundmedicine.com/medline/citation/32651702/Non-acid_Reflux:_When_It_Matters_and_Approach_to_Management L2 - https://dx.doi.org/10.1007/s11894-020-00780-4 DB - PRIME DP - Unbound Medicine ER -
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