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With pH\u2010impedance monitoring, in addition to acid reflux episodes identified by pH drops below 4.0, weakly acid reflux (WAR, pH\u20094\u20137) and nonacid reflux (NAR, pH\u2009&gt;7.0) are also recognized, although both may be included under the umbrella term NAR. However, despite identification of ambulatory pH\u2010impedance monitoring, data on clinical relevance and prognostic value of NAR are limited. The Lyon Consensus, an international expert review that defines conclusive metrics for gastroesophageal reflux disease (GERD), identifies NAR as \u201csupportive\u201d but not conclusive for GERD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This review provides perspectives on whether NAR fulfills three criteria for clinical relevance: whether NAR sufficiently explains pathogenesis of symptoms, whether it is associated with meaningful manifestations of GERD, and whether it can predict treatment efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14671","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T10:04:27Z","timestamp":1694599467000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A perspective on the clinical relevance of weak or nonacid reflux"],"prefix":"10.1111","volume":"35","author":[{"given":"Daniela","family":"Jodorkovsky","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Mount Sinai West &amp; Morningside Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Katzka","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"C. 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