Gastroesophageal reflux disease (GERD) can cause many painful symptoms in a sufferer. These symptoms can include:
- a feeling of pain in the chest area
- difficulty swallowing
- a feeling of food trapped in one’s throat
- hoarseness upon rising
- a sensation of choking,
- bad breath that does not seem to go away no matter what you do
- a persistent dry, hacking cough
Let’s look at ways that this condition is diagnosed.
Most of the time a doctor will prescribe a series of acid-suppressive drugs on a trial basis to see if it does the trick. If the drugs are effective, it then it is often assumed that the diagnosis is GERD. If not, then other medical tests are required to determine the cause of the symptoms.
One of the common tests for GERD is an upper endoscopy (also referred to as esophagogastroduodenoscopy or abbreviated simply to EGD).
In an EGD the doctor uses an endoscope to take a closer look at the inner walls of the esophagus as well as the stomach and duodenum (or the beginning of the small intestine).
The endoscope resembles a thin, lighted tube that is flexible enough to move easily. Using this, the doctor can easily see both walls of the stomach and the tissue that lines the upper part of the digestive tract.
Along with the EGD, a a doctor will sometimes choose to do a biopsy of the stomach or esophagus in order to rule out cancer as a source of the heartburn.
Another procedure that is commonly ordered is the 24-hour esophageal PH monitor examination. This test can be uncomfortable for the patient, as it involved a thin tube with a sensor on the end, being sent down their nose and throat and remaining in place for the length of the examination
This procedure helps to measure the amount of acid that is being “refluxed” into the esophagus and how quickly it is rising. Let us look closer at this procedure.
To begin the procedure the doctor delicately inserts a tube through the patient’s nose and down his throat until it enters the esophagus. As its name suggests, this test spans 24-hours. The sensor tube is connected to a box resembling a Walkman which measures how long acid from the stomach takes to make its way to the esophagus, and for how long it remains there.
The patient is responsible for keeping a record of his symptoms and recording them. At the end of the 24-hour period, the recorded data is analyzed, with close attention paid to the frequency and severity of the symptoms.
The PH monitoring examination is often used for patients who have recurring heartburn symptoms but show a normal exam with the endoscopy and have not seen relief with the acid-suppressive therapy.
Barium x-rays are sometimes used for heartburn sufferers with certain symptoms. The patient is given a barium-laced drink to ingest, and the liquid coats the walls of both the stomach and the esophagus. X-rays are then taken to help identify hiatus hernias, ulcers, erosions or strictures.
Sometimes it is also easy to see how the esophagus empties itself of food and liquids on a barium x-ray. Be aware that barium x-rays are not very effective at diagnosing GERD on their own, and because of this they are often combined with other types of medical procedures to obtain a proper diagnosis.