To what extent does the assessment of typical and atypical troublesome symptoms accurately reflect an objective diagnosis of gastroesophageal reflux disease?

INTRODUCTION: Patients with troublesome reflux‑like symptoms, in whom routine empirical proton pump inhibitor (PPI) therapy is often unsatisfactory, present a therapeutic challenge and are frequently referred for gastroenterological evaluation to confirm a diagnosis of gastroesophageal reflux disease (GERD). OBJECTIVES: We aimed to determine the prevalence of objectively confirmed GERD (diagnosed according to the Lyon Consensus 2.0 criteria) in patients with typical and / or atypical troublesome reflux‑like symptoms who did not respond or partially responded to PPI therapy, and were referred for esophageal pH‑impedance monitoring. PATIENTS AND METHODS: This was a retrospective study analyzing pH‑impedance monitoring results of 500 patients who previously underwent endoscopy. A conclusive GERD diagnosis was defined as an acid exposure time (AET) greater than 6%, or 4%-6% with supporting evidence (number of reflux episodes >80/d, and / or mean nocturnal basal impedance