Telemetry capsule for ambulatory pH monitoring: is it time for a change?

There is currently no clear gold standard for the diagnosis of gastroesophageal reflux disease. The most common practice, a therapeutic trial of antisecretory therapy, falls short of being ideal. Endoscopy is insensitive and impractical as an early diagnostic test for the majority of patient presentations. Ambulatory reflux monitoring offers the most effective means of documenting the presence of abnormal esophageal acid exposure and abnormal reflux frequency and to correlate the association of symptoms and reflux episodes. However, even this diagnostic test has fallen short of being an adequate and reliable standard for diagnosis. Telemetry capsule monitoring offers the opportunity for creative improvement in the diagnostic utility of pH monitoring and is the subject of the study discussed.