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. Author manuscript; available in PMC: 2023 Jan 13.
Published in final edited form as: Clin Gastroenterol Hepatol. 2022 Feb 2;20(5):984–994.e1. doi: 10.1016/j.cgh.2022.01.025

Figure 2.

Figure 2.

Utilization of prolonged reflux monitoring off PPI therapy to characterize severity of GERD. Reflux monitoring is offered in patients without higher grades of reflux esophagitis on endoscopy. Absence of pathologic acid exposure on ambulatory reflux monitoring (AET <4.0% on all 4 days of the prolonged wireless pH study) with a normal endoscopy rules out GERD. Erosive esophagitis of Los Angeles Grade B or higher, and/or AET ≥6.0% on 2 or more days constitutes conclusive GERD evidence. Patients with LA grade A esophagitis, and/or AET ≥4.0% but otherwise not meeting criteria for conclusive GERD are considered to have borderline GERD.