Not everyone who suffers from gestroesophageal reflux disease or GERD will have to undergo extensive testing. A doctor will often begin by asking you questions about your acid reflux symptoms. The most common question is whether or not you feel a burning, warmth, heat or pain just behind the breastbone which is commonly known as heartburn. If you have frequent or severe cases of heartburn then the next step your doctor will take is usually to prescribe medications normally used to treat GERD. This is done before any other tests are conducted. If your symptoms improve while on the medicine then you doctor will usually diagnose you with acid reflux disease and do not further testing.
However, sometimes a doctor will refer you to a specialist called a gastroenterologist who will perform a test called an upper gastrointestinal endoscopy. This allows the doctor to have a look at the inner lining of your esophagus, stomach and the first part of your small intestine through a thin, flexible tube called an endoscope. The endoscopy is used for three things. First it is used to evaluate the esophagus for inflammation and other complications that may have been caused by acid reflux. Second it can be used to rule out Barrett’s esophagus which is another acid reflux complication. Finally it is used to rule out other diseases such as ulcers or cancer. Your doctor will typically order an endoscopy if you have had acid reflux symptoms for a long time, your symptoms do not improve through medication, your symptoms come back immediately after medication is stopped or there are other serious signs present such as weight loss, vomiting of blood or problems with swallowing.
If your doctor cannot get enough evidence that acid reflux is causing your symptoms through the use of an endoscopy then esophageal tests may be done. These test are recommended if your symptoms are not treated with medication, if you have frequent symptoms that place you at risk of Barrett’s esophagus or if you need long-term therapy for you condition.
Esophageal testing includes manometry testing which determines how well the muscles of your esophagus move food into your stomach and how tight the valve between the esophagus an the stomach is when it closes. This testing is often required before you undergo surgery to treat your acid reflux disease. pH monitoring is another test which looks at how often the stomach acid gets into the esophagus and how long it remains there.
X-rays are usually not taken of the esophagus or stomach to diagnose acid reflux disease. However, sometimes they may be done since they can be helpful in determining if there is another problem that can be causing your acid reflux symptoms. These problems can be a hiatal hernia or a narrowing of the esophagus, called a stricture. These X-rays are usually done as a part of a series known as an upper gastrointestinal or UGI series.
The test your doctor performs are based on the acid reflux symptoms you have. Before you agree to any extensive acid reflux testing it is best to ask what information the doctor will gain from the test and how the results will effect your acid reflux treatment.
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