Diagnostic tests for severe Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Diseases (GERD) in very few cases is so severe that your doctor prescribes tests for it. There are only a few types of Acid Reflux which require medical intervention. If you are affected by such a type of Acid Reflux then your doctor will prescribe you one or more of the tests to see how severely damaged your esophagus is and what type of intervention is required for you. Let's see the tests which are done in severe cases of Acid Reflux:

1. Upper Endoscopy: The upper endoscopy allows the doctor to examine the throat, esophagus and the upper part of the small intestine called the duodenum. This is done using a small tube that is inserted through the mouth. The upper part of the tube has a camera with which the doctor is able see the insides of your above mentioned organs and assess how much damage is there to your digestive track. He may also do a biopsy to check if there is any change to the lining of your esophagus to decide if any further monitoring is required.
2. 24 hour Esophageal pH Monitor Examination: This procedure in the most sensitive test for Acid Reflux. In this the doctor inserts a very thin tube through the nose. The patient swallows the tube till it reaches the esophagus. Outside the tube is attached to a walkman sized box which measures how much acid reaches from the stomach to the esophagus in a 24 hour interval. This data is analyzed to monitor the frequency of the reflux and its associated heartburn episodes. This test is done only on those patients who show no improvement in their symptoms of heartburn even after the use of proton pump inhibitors and other acid suppressants.
3. Barium X-rays: This test is not too effective in diagnosing the symptoms of Acid Reflux but is used in conjunction with other tests. In this test the patients drinks a liquid containing barium. The barium lines up the esophageal surface and then X-ray are done to find any abnormality in the digestive track. It will show in there is any ulcer, hiatal hernias, erosion or strictures in the lining of the esophagus.
4. Esophageal Manometry: This is a pressure based test where a tube is inserted from the nose of the patient into the esophagus. Now pressure is measure in the esophageal tube to see if the lower esophageal sphincter is closing up with the required pressure to prevent the reflux of acid from stomach into esophagus.

The best test to diagnose Acid Reflux is the 24 hour Esophageal pH Monitor examination. Barium test and the Manometry tests are not independently sufficient to diagnose the reasons of Acid Reflux but may be used in combination with other tests to verify any conclusion.Also, if you feel uncomfortable in swallowing the tube the doctor may not prescribe it.