Diagnosis of gastroesophageal reflux disease

The diagnosis of gastroesophageal reflux disease (GERD) remains a challenge. The symptoms and manifestations caused by GERD vary from nonerosive reflux disease over Barrett's esophagus to chronic respiratory disease. As a consequence, it is clear that not one investigation technique will provide an answer in all situations. Although many diagnostic techniques are available, most of them are not needed to diagnose GERD. Upper gastrointestinal tract endoscopy with biopsies is indicated to exclude differential diagnoses, but not to diagnose GERD. Multiple intraluminal impedance (MII) has been extensively evaluated in recent years, but will be discussed more in detail in a different chapter.