Evaluating Post-Meal Esophageal High Resolution Impedance Manometry to Diagnose GERD in Patients Still Having Symptoms Despite Proton Pump Inhibitor Treatment

What this Trial Is About

Gastro-esophageal reflux disease GERD causes symptoms like heartburn and regurgitation when stomach contents flow back into the esophagus. Many people take proton pump inhibitors PPI as a first treatment, but up to 60% still experience symptoms. This trial evaluates a new diagnostic method called post prandial esophageal High Resolution Impedance Manometry HRIM to better identify reflux episodes and understand their causes in patients not fully helped by PPI treatment. Participants with ongoing GERD symptoms despite PPI therapy will undergo several tests an upper gastrointestinal endoscopy with biopsies, wireless pH monitoring over 96 hours, and a post meal HRIM test lasting one hour after eating a standardized meal. Optionally, some may also have 24-hour pH-impedance monitoring while on PPI. These tests aim to measure reflux episodes, acid exposure, and esophageal pressures to clarify the diagnosis and guide treatment. During the study, patients will be monitored through these procedures, including a standardized meal intake and probe insertions. Researchers will measure the number of reflux episodes detected by HRIM, acid exposure times, esophageal pressures, and tissue samples. Patient preferences about the examinations will also be recorded. The trial will help determine how well post prandial HRIM identifies GERD in PPI-resistant patients and lasts until May 2027.

Diagnostic Yield of Post PRandial Esophageal High Resolution Impedance Manometry in Patients With Gastro-Esophageal Reflux Disease Symptoms Resistant to Proton Pump Inhibitor Therapy