Relevance of volume and proximal extent of reflux in gastro-oesophageal reflux disease

In patients with gastro-oesophageal reflux disease (GORD), oesophageal and extraoesophageal symptoms are traditionally attributed to increased contact time between the mucosa and refluxates. However, the volume of reflux may be important by increasing the total amount of highly concentrated damaging substances, either by prolonging distal mucosal exposure or by expanding to more proximal areas. To date, it has not been possible to accurately measure the volume of gastro-oesophageal reflux. Determination of the volume of reflux will help to better understand the pathophysiology of GORD and to evaluate the efficacy of antireflux treatments.