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In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.
The M21-1 Adjudication Procedures Manual does not constitute law, in contrast to statutes, federal regulations, and federal case law.The Department of Veterans Affairs has stated, “[t]he M21-1 is an internal manual used to convey guidance to VA adjudicators.
The Rome criteria are achieved and finally issued through a consensual process, using the Delphi method (or Delphi technique). The Rome Foundation process is an international effort to create scientific data to help in the diagnosis and treatment of functional gastrointestinal disorders, also known as disorders of gut-brain interaction. [22]
Impedance–pH monitoring is a technique used in the diagnosis of gastroesophageal reflux disease (GERD), by monitoring both impedance and pH. [1] [2]Patients with ongoing symptoms while on proton-pump inhibitor (PPI) therapy are commonly diagnosed with impedance–pH monitoring while continuing their medications.
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications.
The Achem criteria are more stringent, and are an extension of the study of 93 patients used by Richter and Castell in the development of their criteria, and require amplitudes of greater than 199 mm Hg at 3 cm above the lower esophageal sphincter (LES), greater than 172 mm Hg at 8 cm above the LES, or greater than 102 mm Hg at 13 cm above the LES.
It is the major symptom of gastroesophageal reflux disease (GERD). [6] Other common descriptors for heartburn (besides burning) are belching, nausea, squeezing, stabbing, or a sensation of pressure on the chest. The pain often rises in the chest (directly behind the breastbone) and may radiate to the neck, throat, or angle of the arm.
Gastroesophageal reflux disease (GERD) [13] Excessive gas in the transverse colon caused by: Lactose intolerance; Abnormal gallbladder function and/or blood flow; Gall stones; Sphincter of Oddi dysfunction; Hiatal hernia [14] Cardiac bridge (Coronary occluding reflexes triggered by coronary reflexes) Enteric disease