GERD Tests & Diagnosis
Gastroesophageal reflux disease (GERD) is a chronic disorder in which stomach acid comes up into the esophagus at least twice each week and causes mucosal damage. When stomach acid expels from the stomach, heartburn and acid reflux arise and the lining of the esophagus becomes damaged from the acidity of the gastric fluid. GERD, also known as gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease, is actually a symptom of the mucosal damage. The regurgitation of stomach fluids is a result of abnormalities of the barrier between the stomach and esophagus that is meant to prevent gastric reflux.
Deviant function of the lower esophageal sphincter, a door-like flap at the top of the stomach, results in stomach fluids expelling upwards to the esophagus. This is a hiatal hernia and it may be a chronic malfunction or a transient blip. Hiatal hernias are responsible for the majority of GERD cases.
Upon a patient’s complaint of heartburn and experiencing gastric reflux at least twice each week or the gastric reflux preventing him from performing his daily activities, GERD is a very possible diagnosis. Over-the-counter drugs can mask the pain and discomfort associated with standard heartburn, but many GERD patients experience short-lived relief from such treatments. GERD patients may require prescription drugs or surgery to treat their severe heartburn.
Best Tests for GERD
Tests performed to diagnose GERD:
- Standard endoscopy
- Endoscopy with tissue biopsy
- Esophagogastroduodenoscopy (EGD)
- X-ray with barium swallow
- Ambulatory acid (pH) monitoring probe test
- Esophageal motility test
An endoscopy is performed to examine the stomach and esophagus by inserting a long, thin and flexible tube down a patient’s throat, usually while the patient is sedated. There is an endoscope (light and camera) at the end of the tube to take pictures of the esophagus and stomach. Endoscopies are valuable for examining damage done by gastric reflux. GERD patients may be advised to have endoscopies done five to ten times per year. A biopsy can be taken during an endoscopy for more accurate testing of the severity of the damaged esophageal lining tissue and to test for cancer. An esophagogastroduodenoscopy (EGD) is a type of endoscopy generally performed when a patient does not respond to prescribed drugs to treat GERD or has severe symptoms, such as anemia, voice changes, dysphagia, blood in the stool, wheezing and weight loss.
The X-ray with barium swallow is also known as an upper GI (gastrointestinal) series. This test is performed after the patient drinks barium to coat the lining of his digestive tract to better outline the shape of the esophagus and duodenum (upper intestine). The X-ray images are taken of the upper GI tract with the barium coating.
The most objective test for GERD is the ambulatory acid (pH) monitoring probe test. This test determines how long a patient has been experiencing gastric reflux by measuring the acidity in the esophagus. In this test, a thin and flexible tube with a pH monitor at the end is inserted in the nose and down the esophagus. The monitor determines the pH level in the esophagus throughout a 48-hour period and the levels are recorded in a small computer device worn on the hip. Some patients are told to cease taking GERD drugs during the testing period.
An esophageal motility test examines the motility and pressure of the esophagus. A thin and flexible tube is inserted in the nose and down the esophagus. A probe at the end of the tube measures the way the esophagus moves as a way to determine the severity of the patient’s GERD.
GERD can be very painful, but it does not have to be life altering. There are drugs and surgeries available to ease the symptoms of the disorder. Contact your healthcare provider to discuss the most appropriate course of action to treat your GERD.