In most cases, diagnosis of gastroesophageal reflux disease can be made following a medical examination and a review of symptoms. When symptoms are not typical, or conservative treatment has been unsuccessful, additional testing is required to identify the underlying cause of acid reflux disease.
The most frequently used diagnostic tests for GERD are:
Upper Endoscopy
An esophagogastroduodenoscopy or upper endoscopy allows Dr. Ihde to examine the esophagus and stomach using a long flexible tube housing a tiny camera. This outpatient procedure does not require incisions or anesthesia, and most people tolerate it well. After you receive medication to help you relax, the endoscope is passed into the esophagus, stomach, and first part of the small intestines. The camera in the endoscope transmits an image to a video screen so that Dr. Ihde can see areas that may be damaged by reflux disease. Evidence of vocal cord irritation, inflammation and scarring of the esophagus, hiatal hernia, gastritis, gastric ulcers, polyps, duodenal ulcers, and duodenitis can be evaluated with the endoscope.
pH Study
The strength of an acid is measured by its pH. During a pH study, a thin catheter is passed through the nose and down into the esophagus. Over a 24-hour period, the patient goes about his or her normal activities, while keeping a log of meals and any reflux symptoms. The catheter measures the pH or acidity of any liquid in the esophagus and can detect when acid refluxes into the esophagus, helping to determine the severity of the reflux.
Manometry
Manometry is used to measure the effectiveness of the lower esophageal sphincter (LES) at preventing reflux. A manometer measures pressure at various points in the esophagus and stomach. The results of this test help identify muscular abnormalities and nerve conduction problems that interfere with normal LES function. Manometry can identify when laparoscopic fundoplication or Transesophageal Incisionless Fundoplication are viable treatment options for GERD and which type of procedure is the best option.
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