{:highlights [{:id #uuid "65bff94f-c6f4-4d7e-b7f3-846f059c3db5", :page 3, :position {:bounding {:x1 508.0625, :y1 130.9479217529297, :x2 906.7697143554688, :y2 330.1666717529297, :width 992.1266666666666, :height 1322.8349999999998}, :rects ({:x1 508.0625, :y1 130.9479217529297, :x2 906.6722412109375, :y2 147.6145782470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 691.40625, :y1 146.5520782470703, :x2 906.5989990234375, :y2 157.8854217529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 149.1979217529297, :x2 691.3969116210938, :y2 165.8645782470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 715.4166870117188, :y1 149.1979217529297, :x2 906.5989990234375, :y2 165.8645782470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 167.3229217529297, :x2 906.6212158203125, :y2 183.9895782470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 185.7083282470703, :x2 906.7425537109375, :y2 202.37501525878906, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 203.96876525878906, :x2 906.7655029296875, :y2 220.6354217529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 566.8958740234375, :y1 219.7083282470703, :x2 906.7326049804688, :y2 231.0416717529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 222.21876525878906, :x2 567.068603515625, :y2 238.8854217529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 580.2916870117188, :y1 222.21876525878906, :x2 906.7326049804688, :y2 238.8854217529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 240.4791717529297, :x2 906.7569580078125, :y2 257.1458282470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 258.7291717529297, :x2 906.7697143554688, :y2 275.3958282470703, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 276.9895782470703, :x2 906.75537109375, :y2 293.65626525878906, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 295.37501525878906, :x2 906.6832275390625, :y2 312.0416717529297, :width 992.1266666666666, :height 1322.8349999999998} {:x1 508.0625, :y1 313.50001525878906, :x2 605.8724975585938, :y2 330.1666717529297, :width 992.1266666666666, :height 1322.8349999999998}), :page 3}, :content {:text "Non-acid reflux. Non-acid GER involves the reflux of gastric contents with a pH 44.13 Esophageal hypersensitivity involves the perception of “not-abnormal reflux,” which may include episodes of non-acid reflux; these may be influenced by the degree of esophageal distension and/or higher reflux volumes.7 Duodenogastroesophageal reflux (DGER) is the reflux of duodenal contents into the esophagus, which can potentially be diagnosed by measuring the bilirubin level in the refluxate, 13 although accurate measurement is problematic. Bile reflux is uncommon, accounting for only 10–15% of non-acid reflux"}, :properties {:color "green"}} {:id #uuid "65bff973-502b-4ef6-94c6-2910b604a133", :page 4, :position {:bounding {:x1 153.47726440429688, :y1 715.375, :x2 245.57781982421875, :y2 732.0416870117188, :width 992.1266666666666, :height 1322.8349999999998}, :rects ({:x1 153.47726440429688, :y1 715.375, :x2 245.57781982421875, :y2 732.0416870117188, :width 992.1266666666666, :height 1322.8349999999998}), :page 4}, :content {:text "Rome criteria"}, :properties {:color "red"}} {:id #uuid "65bff9b3-a93b-490b-b6f9-12bf50fddd46", :page 5, :position {:bounding {:x1 79.76042175292969, :y1 1062.6146640777588, :x2 478.5605926513672, :y2 1207.0729160308838, :width 992.1266666666666, :height 1322.8349999999998}, :rects ({:x1 79.76042175292969, :y1 1062.6146640777588, :x2 478.34881591796875, :y2 1079.2812900543213, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1080.7396640777588, :x2 478.39256286621094, :y2 1097.4062900543213, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1098.9896640777588, :x2 478.36021423339844, :y2 1115.6562900543213, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1117.3854160308838, :x2 478.1787109375, :y2 1134.0521640777588, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1135.6354160308838, :x2 478.49815368652344, :y2 1152.3021640777588, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1153.8959140777588, :x2 478.28900146484375, :y2 1170.5625400543213, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1172.1459140777588, :x2 478.5605926513672, :y2 1188.8125400543213, :width 992.1266666666666, :height 1322.8349999999998} {:x1 79.76042175292969, :y1 1190.4062900543213, :x2 222.16781616210938, :y2 1207.0729160308838, :width 992.1266666666666, :height 1322.8349999999998}), :page 5}, :content {:text "Extraesophageal symptoms. GERD symptoms can be divided into esophageal/typical symptoms, such as regurgitation and heartburn, or extraesophageal/atypical symptoms, such as globus, chronic cough, and/or hoarseness. The Montreal Consensus has acknowledged links between GERD and these extraesophageal symptoms; however, despite multiple epidemiological studies identifying a link, causality cannot be concluded. "}, :properties {:color "purple"}} {:id #uuid "65bffa39-81f5-49d1-9ec2-e4ab3b214105", :page 6, :position {:bounding {:x1 86.3125, :y1 496.3125305175781, :x2 485.11285400390625, :y2 604.3854370117188, :width 992.1266666666666, :height 1322.8349999999998}, :rects ({:x1 86.3125, :y1 496.3125305175781, :x2 173.6041717529297, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 184.7291717529297, :y1 496.3125305175781, :x2 208.625, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 219.85418701171875, :y1 496.3125305175781, :x2 322.5208435058594, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 333.0520935058594, :y1 496.3125305175781, :x2 377.6875, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 388.51043701171875, :y1 496.3125305175781, :x2 449.5208435058594, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 460.4375, :y1 496.3125305175781, :x2 484.9871826171875, :y2 512.9791870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 86.3125, :y1 514.5625305175781, :x2 484.98431396484375, :y2 531.2291870117188, :width 992.1266666666666, :height 1322.8349999999998} {:x1 86.3125, :y1 532.8229370117188, :x2 484.84429931640625, :y2 549.4895935058594, :width 992.1266666666666, :height 1322.8349999999998} {:x1 86.3125, :y1 551.0729370117188, :x2 485.1063232421875, :y2 567.7395935058594, :width 992.1266666666666, :height 1322.8349999999998} {:x1 86.3125, :y1 569.3333435058594, :x2 485.11285400390625, :y2 586.0000305175781, :width 992.1266666666666, :height 1322.8349999999998} {:x1 86.3125, :y1 587.7187805175781, :x2 355.1630859375, :y2 604.3854370117188, :width 992.1266666666666, :height 1322.8349999999998}), :page 6}, :content {:text "Esophageal pH monitoring. A widely available and accepted test for measuring esophageal acid exposure remains ambulatory pH monitoring.39,40 Prolonged (48–96 h) wireless pH monitoring as compared with the catheter-based systems increases the likelihood of detecting reflux disease in patients undergoing symptom evaluation"}, :properties {:color "blue"}} {:id #uuid "65bffaa1-3c7b-4554-82e9-7892f4f52b87", :page 8, :position {:bounding {:x1 145, :y1 1631.8646240234375, :x2 814.8333740234375, :y2 1659.8646240234375, :width 1666.7727999999997, :height 2222.3628}, :rects ({:x1 145, :y1 1631.8646240234375, :x2 814.8333740234375, :y2 1659.8646240234375, :width 1666.7727999999997, :height 2222.3628}), :page 8}, :content {:text " any data about its role in non-responders. However, it is"}, :properties {:color "blue"}}], :extra {:page 4}}