Gastroesophageal Reflux Disease and Reflux-like Phenotypes: Using Lyon Consensus 2.0 to Guide Clinical Approach

Area of Science:

• Gastroenterology
• Esophageal Disorders
• Gut-Brain Interaction

Background:

• Gastroesophageal reflux disease (GERD) is a prevalent global condition.
• Troublesome symptoms alone are insufficient for a definitive GERD diagnosis.
• Existing consensus criteria (Montreal, Lyon, Rome) offer frameworks for diagnosis and phenotyping.

Purpose of the Study:

• To explore the interrelationships between Montreal, Lyon, and Rome criteria.
• To define distinct phenotypes in patients with reflux-like symptoms.
• To guide accurate phenotyping and optimal patient management.

Main Methods:

• Review and synthesis of Montreal, Lyon, and Rome consensus criteria.
• Analysis of diagnostic criteria for GERD and esophageal disorders of gut-brain interaction (E-DGBI).
• Identification of overlapping concepts and distinct phenotypes.

Main Results:

• GERD diagnosis requires evaluation of mucosal injury and reflux burden, as per Lyon Consensus.
• Rome V criteria for E-DGBI necessitate the exclusion of GERD.
• Distinct phenotypes include mucosal injury, abnormal reflux burden, and E-DGBI, with potential overlap and coexistence.

Conclusions:

• Accurate phenotyping of GERD and related disorders relies on integrating multiple consensus criteria.
• Phenotype identification guides targeted management strategies for symptom relief and complication prevention.
• Understanding the interplay between criteria is crucial for comprehensive patient care.