Learn more about how to diagnose acid reflux and GERD in order to maintain a quality life without pain. If you suspect you are suffering from GERD, the first step is to visit your health care provider. Your health care provider will be able to assess you based on your history and physical examination. During your visit, your health care provider may also use a procedure known as upper endoscopy to view your oesophagus, which may reveal inflammation or other complications. During this procedure, your health care provider will take x-rays of your oesophagus and perform an acid reflux test to determine the level of your stomach acids.
The physical exam and questioning of the patient may be enough to make a diagnosis. However, certain tests may be required to confirm the diagnosis. The ambulatory 24-hour pH probe is the gold standard for diagnosing GERD. The oesophagal uses X-ray imaging to see the lower oesophagus and may also reveal a weakened oesophagus.
Symptoms of acid reflux and GERD may include heartburn more than twice a week, a chronic cough, or chest pain. The symptoms of reflux disease are similar to those of heartburn and regurgitation, although some individuals do not experience either. Other symptoms of GERD include chest pain, hoarseness in the morning, and difficulty swallowing. Bad breath may also be a symptom of GERD. Heartburn is a burning sensation in the chest that is caused by acid from the stomach.
When diagnosing acid reflux and GERD, doctors look for several symptoms. One of these symptoms is regurgitation when stomach contents flow back into the mouth or throat. The acid is mixed with undigested food and causes this problem. It can be uncomfortable and potentially harmful, but there are many other symptoms that may be present as well. The diagnosis for GERD isn’t always as simple as identifying the underlying condition, so a provider may recommend some tests.
A gastroenterologist may order an endoscopy, a test that involves inserting a thin tube through the nose and into the oesophagus. The doctor can then measure the acid levels in the oesophagus by examining the lining with a camera. Before this test, a gastroenterologist may administer a sedative to the patient, and an analgesic spray may be sprayed on the throat to ease the pain. The test is not painful and usually lasts about 20 minutes. It may reveal esophagitis or Barrett’s oesophagus, which are both associated with GERD. Surgical procedures can also be recommended to address the problem.
Oesophageal manometry is a diagnostic procedure that uses a small pressure-sensitive tube to measure the contractions of the oesophagal muscles. The patient lies on their side and swallows a small amount of water. The doctor records the contractions and interprets the results. This test can help pinpoint the causes of oesophagal symptoms.
The test is a fast and relatively safe procedure. The benefits outweigh the risks. While it is not a reliable diagnosis of GERD, it can help doctors identify underlying oesophagal problems that may be contributing to symptoms. Patients usually undergo this test if they’ve had a history of acid reflux or GERD. Oesophageal manometry is a great tool for diagnosing GERD, but you should always discuss your symptoms with your doctor before performing it.
Ambulatory 24-hour pH probe
An ambulatory 24-hour pH probe is a diagnostic test that measures the amount of acid in the patient’s oesophagus. It uses a thin probe to measure acid in the oesophagus. The patient carries the device around for 24 hours. After the test, the patient should return to the doctor to review the data and discuss treatment options.
During the test, a pH probe is placed about 5 cm above the lower oesophagal sphincter. The patient records their symptoms and changes in pH throughout the 24 hour period. Statistical analyses are based on percentages of the total time that the pH remains below 4.0. The pH probe also includes additional sensors that detect proximal reflux episodes.
If your symptoms are consistent and severe, your doctor may recommend an upper endoscopy to diagnose GERD or acid reflux. This diagnostic test can be helpful in identifying underlying conditions or determining a treatment plan. The average person with acid reflux will undergo an upper endoscopy at least once in their lifetime. It may be necessary to have an upper endoscopy at some point in the course of their disease, particularly if they have a history of severe GERD or oesophagal stricture.
There are several different types of endoscopies. A screening upper endoscopy may detect Barrett’s oesophagus. After diagnosis, patients may undergo endoscopic surveillance every three to five years. Patients with high-grade dysplasia may require more frequent examinations. However, if your symptoms are not treated promptly, you may experience an acute attack of acid reflux or GERD.
Although many doctors have a hard time defining what constitutes a “refractory” GERD, most experts define it as a failure of PPI therapy if the patient’s symptoms do not respond to the drug after two to four weeks. In other words, the patient does not respond to PPI therapy but has persistent symptoms. Symptoms may not be responsive to PPI treatment for a variety of reasons, including insufficient suppression of stomach acid.
The dosage of proton pump inhibitors varies. Some doctors prescribe them ‘as needed,’ while others suggest a daily dosage. However, it is important to note that many of these drugs reduce the diversity of the “friendly” bacteria in the intestines, which is essential to aid digestion, the absorption of vitamins, and other important body functions. Consequently, it is important to monitor the dosage closely, since symptoms may return after stopping the medication.