Diagnosing Acid Reflux

Diagnosing Acid Reflux for severe heartburn symptoms and the frequency with which they are experienced is typically the marker. However, those same symptoms could also indicate the presence of other issues so, at times, it is important to use testing that will provide measurable proof that the disease is or isn’t present.

This is especially true if prescription products offer little or no relief. If your family physician suspects that you have acid reflux , you may be referred to a specialist for one or more of the following types of assessments that will help confirm or rule out any underlying issues:

  • Barium Swallow Test: For this test, the patient swallows a chalky, milkshake-like substance that coats the throat and esophagus so that "swallowing" motions can be viewed on an x-ray. Physicians often use fluoroscopy, which is like an x-ray movie, to view body parts and their motions in great detail. During this process, a continuous x-ray beam is passed through the part of the body being studied and the images are transmitted to a monitor for the physician to review.

  • Endoscopy: Also called an EGD or esophagogastroduodenoscopy. This procedure, which is usually carried out by a Gastroenterologist, is one in which a small, flexible tube containing a microscopic "camera" is swallowed by the patient. Images captured by the "camera" are projected onto a large screen and examined by the physician. The test does not interfere with your breathing and you will (1) have your throat sprayed with a numbing agent prior to the procedure or (2) be given an intravenous sedative. This tool is used most frequently in diagnosing acid reflux.

  • Esophageal Acid Testing: Also called pH Testing. This "gold standard" for diagnosing acid reflux, is used to determine the different levels of esophageal acidity during a twenty-four hour period. During this test, the patient is required to wear a small probe that is inserted through the nostril and positioned at or near the lower esophagus. The probe is attached to a monitor that is worn around your neck, on your waist or over your shoulder and it captures data that is used for diagnosis. Because of the length and invasive nature of this test, it can be cumbersome.

  • Bernstein Test: Also called an Acid Perfusion Test. This test, which is typically performed in a laboratory when diagnosing acid reflux, is used to actually reproduce heartburn symptoms. A tube, which is inserted through your nostril and into your esophagus, is infused with alternating solutions of a mild hydrochloric acid and saline. The patient is not aware of which solution is being used and they are asked to report the times when they feel pain. This method is not frequently used.

  • Gastric Emptying: This study examines how rapidly food in the stomach is emptied into the small intestine. It is done by monitoring and tracking the movement of ingested food that has been mixed with a minute amount of radioactive chemicals. The procedure is very safe as none of the radioactive material is absorbed by the body.

  • Esophageal Manometry: This test determines how well the muscle of the esophagus works when diseases of the muscle are suspected. A nostril is anesthetized with a numbing lubricant. A flexible plastic tube that is about 1/8'' diameter is then passed through the anesthetized nostril, down the back of the throat, and into the esophagus as the patient swallows. Once inside the esophagus, the tube allows the pressures generated by the esophageal muscle to be measured when the muscle is at rest and during swallows. The procedure lasts about 20 to 30 minutes.

Many other tests and procedures can be used when diagnosing acid reflux. The x-ray, which has long since been abandoned as a means of diagnosing GERD, can still be used in conjunction with an endoscopy to determine and evaluate existing complications. ENT (ear, nose and throat) specialists can also diagnose acid reflux by examining the throat and larynx.

Biopsies, although not typically used, can be helpful in diagnosing mouth, stomach and esophageal cancers related to the disease. Regardless of method by which you are diagnosed, quantitative methods such as these are far better than their qualitative counterparts.

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