The clinical manifestations of non-erosive gastroesophageal reflux disease (NERD) are multiple and heterogeneous, and differ according to age and individual susceptibility. Weakly acidic reflux and the presence of gas in the refluxate could be relevant in the pathogenesis of symptoms. We present the case of a 3-year and 5-month-old child who came to the hospital with recurrent paroxysmal manife...

We read with great interest the recently published article by Moschos et al [1]. They aimed to show the beneficial effect of Helicobacter pylori (Hp) eradication in gastroesophageal reflux disease (GERD) patients. They indicated in this study that Hp eradication may positively influence GERD symptoms. We commend Moschos et al for this study, but we think there are some controversial situations ...

OBJECTIVE Thickening of formula feedings is part of the therapeutic approach for gastroesophageal reflux (GER) in infants. However, its mechanism of action, especially regarding the occurrence of nonacid (pH >4) GER, has not yet been clearly described. The aim of this randomized, placebo-controlled crossover study was to examine the influence of formula thickened with carob (St. John's bread) b...

BACKGROUND/AIMS Impedance-pH monitoring allows detailed characterization of gastroesophageal reflux and esophageal activity associated with reflux. We assessed the characteristics of nocturnal reflux and esophageal activity preceding and following reflux. METHODS Impedance-pH tracings from 11 healthy subjects and 76 patients with gastroesophageal reflux disease off acid-suppressive therapy we...

TO THE EDITOR: We would like to appreciate the interest shown on our study by Dr. Cho. Our response to her queries is as follows: (1) We do agree that doubling the proton pump inhibitor (PPI) dose could be the most appropriate therapeutic strategy for gastroesophageal reflux disease (GERD) patients who are refractory to single dose of PPI before performing a pH-impedance measurement. However, p...

BACKGROUND AND AIM The reason that some reflux episodes evoke symptoms is poorly understood, therefore the aim of this study is to assess the determinants of reflux perception in patients with non-erosive reflux disease (NERD) on proton pump inhibitor (PPI) therapy. METHODS Ten NERD patients with persistent symptoms, despite double-dose PPI therapy, were included in this study. All patients h...

BACKGROUND Combined impedance-pH testing (MII) allows for detection of reflux episodes regardless of pH. However impedance-based diagnosis of reflux may not routinely account for duration of the reflux episode. We hypothesize that impedance testing may be less sensitive than pH-testing in detecting acid reflux off therapy as a result of discounting duration of exposure. METHODS Baseline chara...