Diagnosis And Testing
Diagnosis and Testing
For most patients, your doctor may be able to diagnose GERD based on your symptoms and a physical exam, without the need to do further testing. Usually, patients are given a trial of heartburn medication called proton pump inhibitors (Prilosec, Nexium, Protonix Prevacid, Aciphex). If the symptoms improve with the medication you most likely have GERD.
Further testing may be necessary if your symptoms do not respond to the medication, if you have atypical symptoms, or if your symptoms come back after stopping the medications. If additional tests are needed you will be referred to a specialist such as a gastroenterologist or surgeon who are experienced in treating patients with GERD. They may recommend other tests such as:
- Endoscopy: A flexible tube equipped with a light and camera (endoscope) is inserted into the esophagus, allowing the physician to view, photograph and, if necessary, biopsy (remove a tissue sample) the inside of your esophagus. This exam may also be referred to as a gastroscopy, esophagoscopy or EGD.
- Barium swallow: Barium is a thick, chalky liquid. When swallowed, it makes the esophagus and stomach show up on x-rays.
- pH-probe: The doctor will attach a small probe to the inside of your esophagus when he endoscopes you.. The probe is wirelessly connected to a monitor worn around the waist or with an over-the-shoulder strap that records acid levels and reflux activity for 48 hrs. You will be asked to stop your medication for this test and asked to keep a diary about your symptoms.
- Esophageal manometry: When you swallow, muscles in the esophagus contract to push food into the stomach. A tube is inserted into the throat to measure muscle contractions in the esophagus when swallowing.
- Impedance-pH: A small tube in passed through your nose into the esophagus. This tube contains sensors that can determine if the reflux has an acid or non acid character. It can also tell whether fluid is passing down to your stomach or backwards up to your mouth (GERD). The tube is left in place for 24 hrs and like the ph_probe, you will be required to stop your heartburn medications.
- Pharyngeal pH: For patients with predominantly symptoms attributable to the throat such as cough, laryngitis, sore throat, a small probe can be passed via your nose into the back of your throat. This probe is worn for 24 hrs and it is used to detect acid or base that has passed all the way up from your stomach to the back of your throat.