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I. Selection of volunteers as healthy individuals is erroneous. First, gastroesophageal reflux disease (GERD) for a long time can proceed without clinical manifestations. So, for example, with a screening gastroscopy examination of 6,683 healthy Koreans, 14.66% had GERD diagnosed(3). In another study of 57 healthy subjects, 13 (23%) had an esophageal pathology in endoscopy, and 10 (17%) had an esophageal hernia(4). Secondly, as histological studies of recent years have shown, GERD begins with reflux only into the abdominal segment of lower esophageal sphincter (LES), when the acidic gastric contents do not yet enter the esophagus, and, consequently, the disease cannot be detected using pH-metry. There are no symptoms of GERD at this stage(5). Since no histological studies have been carried out, the selected volunteers cannot be considered healthy and therefore the obtained results cannot be considered normative.

REACTION TO ARTICLES ON HIGH RESOLUTION MANOMETRY, THE LENGTH OF THE LOWER ESOPHAGEAL SPHINCTER AND THE DIAGNOSIS OF GASTROESOPHAGEAL REFLUX DISEASE