The Tests Your Doctor May Run for Acid Reflux - dummies

The Tests Your Doctor May Run for Acid Reflux

By Patricia Raymond, Michelle Beaver

Because acid reflux is so common and generally doesn’t result in further medical complications, it’s common for physicians to diagnose acid reflux based on symptoms alone. If you experience mild or infrequent reflux symptoms, your doctor probably won’t want to do any extra testing. Unless she’s afraid it’s something more serious, like GERD, your doctor will likely avoid uncomfortable and sometimes expensive testing.

That said, there are several different medical tests and procedures that doctors use to help assess the severity of acid reflux or GERD.

Upper endoscopy

Upper endoscopy is a simple and generally painless procedure that can be helpful in diagnosing acid reflux or GERD. It’s a quick outpatient procedure, which means you won’t have to stay in the hospital.

The procedure usually involves light sedation given into your vein. After you’re sedated, a doctor will slide a slender tube (with a tiny embedded camera and light) down your throat and esophagus into the stomach.

The camera allows the doctor to examine the esophagus and stomach. He can look for and identify any abnormalities or potential problem areas, and also assess the damage that reflux has done to your esophagus. This is usually the only test your doctor will need to confirm a case of acid reflux or GERD.

In some instances, your doctor may want to perform a biopsy. In this case, the doctor will send a tiny pair of tweezers through the endoscope and remove small pieces of tissue from your esophagus for analysis. The tissue samples will be examined by a pathologist using a microscope. This will help assess the reflux-related damage and rule out any other problems or causes.

Bravo pH probe

A Bravo pH probe is a capsule-based test that allows physicians to collect information over multiple days. This text can help them assess the frequency and duration of acid reflux. This test may be recommended if your doctor wants to confirm that your symptoms are the result of GERD and not something else.

Unlike some of the other pH tests, Bravo pH probes are catheter free. During the upper endoscopy procedure, your doctor will temporarily pin a miniature pH capsule to the lower end of your esophagus. This capsule will then transmit information to a small receiver that’s worn on a shoulder strap or waistband.

The nice thing about this type of testing is that it allows you to go about your normal daily activities without much inconvenience. During this procedure, you can take off the receiver to shower or sleep without affecting the results. Being able to do your daily routine can also provide your physician with a more accurate picture of your acid reflux.

Impedance pH probe

An impedance pH probe is another type of probe your doctor may recommend. This test is performed to detect reflux activity over a 24-hour period. The test allows physicians to categorize reflux symptoms as either acidic or nonacidic.

This can help your doctor assess what types of treatment would be most effective, especially if your current treatment isn’t working well. It can also be used after treatment has begun to determine just how effective your current treatment regimen is at controlling your acid.

The procedure begins with an esophageal motility test, which allows your physician to determine the correct placement of the probe. During this part of the procedure, a specially trained nurse will insert a small catheter in the nostril down into the stomach. You’ll be asked to take small sips of water as the nurse slowly withdraws the catheter.

After the motility test is completed, the nurse will insert the impedance pH probe through your nose, using a different specially designed catheter. This catheter will come out your nose and be attached to the receiver unit. The probe will stay in place for 24 hours, sending information to a special receiver that you’ll carry on a strap over your shoulder.

You’ll have to return the following day to have the probe removed. The nurse will also ask you fill out a diary to record specific events during that 24-hour period.

Pharyngeal pH probe

Your physician may recommend a pharyngeal pH probe if he suspects that your reflux is causing respiratory or laryngeal problems. Typical laryngeal problems associated with acid reflux and GERD include hoarseness, coughing, excessive throat clearing, and asthma.

During this test, your doctor will insert a catheter in the nostril and down into the esophagus, and place the pH probe in a specific location in your esophagus. The probe has two monitors for pH levels; the first is placed just above the LES and the second monitor is located just below the upper esophageal sphincter.

This test can help your doctor determine if the abnormal acid exposure is due to acid reflux or something else. If both probes detect high levels of acid exposure, it’s a safe bet that your problems are due to acid reflux. If only the lower probe detects increased acid exposure, it can be a sign that your laryngeal symptoms may be the result of some other problem.

Esophageal motility testing

If you have difficulty swallowing, your doctor may recommend esophageal motility testing, otherwise known as esophageal manometry. This test measures the esophagus function, as well as LES function. During this procedure, the motility nurse will insert a small, flexible catheter through your nostril down into the esophagus and stomach.

Over a period of about 20 minutes, she’ll slowly withdraw the catheter. The nurse will ask you to swallow frequently throughout the procedure. This enables the medical staff to measure the pressure at different points in your esophagus. The catheter is attached to a device that records these measurements for analysis. Don’t worry though — this catheter only remains in your nose for less than a half hour!

This test can help your physician determine whether your difficulties swallowing are due to acid reflux or something else. The procedure can also be helpful in determining the most effective treatment regimen for your acid reflux or GERD.