Diagnosing Acid Reflux

Most of the time, a diagnosis of reflux is made on the symptoms the patient reports. Symptoms of acid reflux may include:

  • taste of acid
  • belching
  • frequent clearing of the throat 
  • sore throat or sore mouth
  • hoarseness
  • difficulty swallowing

However, there are a few tests that can be performed to confirm the diagnosis, including:

Upper endoscopy

Also known as the esophagogastroduodenoscopy or EGD, this acid reflux diagnostic test uses a camera mounted on a thin, flexible cable that is threaded down the patient’s throat, allowing a doctor to see the esophagus, stomach and the upper part of the small intestine. The doctor can take a small sample of tissue to examine for inflammation.

Barium X-rays

The patient swallows barium, a chalky liquid that helps to highlight the esophageal anatomy. Using a technology known as fluoroscopy, the radiologist can also watch the barium traveling down the esophagus to see if there are any abnormalities in motility, the movement of muscles in the esophagus.

Esophageal manometry

This test is designed to show the strength and coordination of the muscles used in swallowing. A narrow, soft tube slides through the nose, down the throat and stops just above the lower esophageal sphincter. It remains there for a set period of time, usually less than 24 hours, to measure the pressure the muscles in the esophagus exert.

Esophageal pH testing

This diagnostic test involves a small capsule, about the size of an acetaminophen gel tablet, that is temporarily attached to the wall of the esophagus. The capsule measures the acidity levels in the esophagus and transmits these measurements wirelessly to a machine the size of a pager, which is worn on the patient's waistband for 48 hours. The patient records the symptoms as they occur in a diary. At the end of the study, the pager-sized machine will be returned to the endoscopy unit; the capsule will naturally pass through the digestive tract. The diary should be turned in at the same time that the machine is returned to endoscopy.

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