Strengths of the study
Unlike previous studies, this study analyzed various parameters of 24-h MII-pH monitoring in patients with LPR responding well and refractory to PPI therapy prospectively. We focused on parameters, such as proximal all reflux time and proximal longest reflux time, which are apt to be overlooked in 24-h MII-pH monitoring when diagnosing LPR. We also compared the responder rates and treatment periods in patients with no reflux and those with LPR to assess the usefulness of empirical PPI therapy and the need for 24-h MII-pH monitoring in patients with suspected LPR.