[pH-impedancemetry: clinical implications]

Gastroesophageal reflux disease is a common condition that requires no additional exam if the diagnosis is straightforward and no complications is suspected. pH monitoring is often used for atypical symptoms or if there is no response to therapy with proton pump inhibitors. This was considered for decades as a "gold standard", but it shows many limits, especially because it only measures acid exposure. pH-impedance monitoring is a new technique that detects all types of reflux (gas-liquid and acid-weakly acid) and evaluates the relationship between symptoms and reflux events. It identifies patients with symptoms related to weakly acid reflux, that is not detected by conventional pH monitoring.