Implications of the Updated Lyon Consensus 2.0 in Clinical Practice

Over the past few decades, efforts have been made to refine the characterization of gastroesophageal reflux disease (GERD) and delineate accurate diagnostic criteria. The original Lyon Consensus published in 2018 defined conclusive diagnostic criteria for GERD, and its subsequent iteration, Lyon Consensus 2.0, provides an updated assessment for actionable GERD. We aim to review the modifications made to the updated consensus, review the supporting literature for said changes, and highlight how these changes may alter clinical practice. The key revisions in the updated consensus are the recommendations to discontinue antisecretory therapy before endoscopic grading, the modifications to endoscopic criteria for proven GERD, the incorporation of wireless pH testing parameters, and the establishment of the threshold for pH-impedance monitoring on antisecretory therapy. Apart from enhancing diagnostic reliability using conclusive and inconclusive thresholds for defining GERD, Lyon Consensus 2.0 provides medical and surgical clinicians the guidance they need to provide clear management pathways for patients with GERD symptoms.