American Gastroenterological Association medical position statement: Guidelines on the use of esophageal pH recording

The following guidelines were developed to assist the physician in the appropriate use of esophageal pH recording in patient care. They emanate from a comprehensive review of the medical literature pertaining to the pH recording technique.¹ Esophageal pH recording is widely available and, when done in a technically appropriate manner, provides quantitative data on both esophageal acid exposure and on the temporal correlation between patient symptoms and reflux events. Despite these strengths, the inherent weakness of the technique is its inability to prove causality between symptoms or syndromes and acid reflux events. Alternatively, causality is reasonably assumed in clinical practice by the substantial reduction or elimination of suspected reflux symptoms during a therapeutic trial of a proton pump inhibitor. In view of this viable alternative, the major indications for esophageal pH monitoring are in documenting the failure of either medical or surgical therapy. This position statement should help the clinician apply esophageal pH studies most beneficially within the context of other clinical options.GASTROENTEROLOGY 1996;110-1981