Usually a description of your symptoms will be
all your doctor needs to establish the diagnosis of heartburn. However, if your
symptoms are particularly severe or don''t respond to treatment, you may need to
undergo other tests to check for GERD and other conditions: Barium
X-ray. This procedure requires you to drink a chalky liquid that coats
and fills the hollows of your digestive tract. The coating allows your doctor
to see a silhouette of the shape and condition of your esophagus, stomach and
upper intestine (duodenum). X-rays can also reveal whether a hiatal hernia may
be contributing to your heartburn. They can also reveal an esophageal narrowing
or stricture, or a growth, which may cause difficulty swallowing. Endoscopy.
A more direct test for diagnosing the cause of heartburn is
esophagogastroduodenoscopy (EGD). In this test your doctor inserts a thin,
flexible tube equipped with a light and camera (endoscope) down your throat.
The endoscope allows your doctor to see if you have an ulcerated or inflamed
esophagus (esophagitis) or stomach (gastritis). It can also reveal a peptic
ulcer. During an EGD, your doctor can take tissue samples to test for Barrett''s
esophagus — a condition in which precancerous changes occur in cells in your
esophagus — or esophageal cancer, two potential complications of severe
heartburn. Your doctor also may take biopsies of the stomach that may reveal
the presence of a bacterium that may cause peptic ulcers. Some of the reasons
you may need an endoscopy are if medications aren''t working for you, you have
had GERD symptoms for a long time, you experience difficulty swallowing, weight
loss, regurgitation of blood or black material, or your doctor is not sure
whether you have GERD. Although endoscopy results often appear normal despite
GERD, sometimes endoscopy can reveal inflammation, stricture, Barrett''s
esophagus or cancer. Ambulatory acid (pH) probe tests. These
tests use an acid-measuring (pH) probe to identify when, and for how long,
stomach acid regurgitates into your esophagus. This information can help your
doctor determine how best to treat your condition. In the standard tube test, a
nurse or technician sprays your throat with a numbing medication while you''re
seated.
Then a thin, flexible tube (catheter) is threaded through your nose
into your esophagus to insert the probe. The probe is positioned just above the
lower esophageal sphincter. A second probe may be placed in your upper
esophagus. Attached to the other end of the catheter is a small computer that
you wear around your waist or with a strap over your shoulder during the test.
It records acid measurements. After the probe is in place, you go about your
business and then come back one or two days later to have the device removed.
Another ambulatory test called a Bravo pH probe may be more comfortable than
the standard test, because it eliminates the need for a tube in your nose. In
the Bravo test, the probe is attached to the lower portion of your esophagus
during endoscopy. The probe transmits a signal to a small computer that you
wear around your waist for about two days, and then the probe falls off to be
passed in your stool. Another benefit of the Bravo test is that you can shower
and sleep more comfortably than with the standard test. Generally, if you have
symptoms of GERD your doctor will likely first treat you with medication. If
the medication doesn''t work or you have side effects and can''t tolerate it,
your doctor may order an ambulatory acid (pH) probe test. Esophageal
impedance. Rather than measuring acid, this test can measure whether
gas or liquids reflux back into your esophagus. It''s helpful for people who
have regurgitation or reflux of materials in the esophagus that aren''t acidic
and wouldn''t be detected by a pH probe. The test works by placing a catheter
through your nose and into your esophagus, similar to a standard pH probe, because the test is new, its role in helping people with GERD
hasn''t been clearly defined