CARE ! - ACID REFLUX DIAGNOSIS

Pain behind breastbone? Acid reflux diagnosis hopefully, as some of the alternatives are rather more dangerous to say the least. Common things often coexist by pure chance, so a medical check for coronary artery disease is always in order.


Difficult or painful swallowing, weight loss, age over 50 or quite recent onset of symptoms are important things to tell your doctor.

HOW TO - ACID REFLUX DIAGNOSIS

An acid reflux diagnosis at endoscopy is only possible if the lining of your lower esophagus is visibly damaged by the reflux, or has microscopic damage seen on biopsy.

Another test for acid reflux is pH monitoring. You have a tiny probe in your gullet for 24 hours and wear a small recording device.
Episodes of acid reflux show up as drops in pH. The total time with reflux is added up, giving a score*.

This test is also used to determine what dose of proton pump inhibitor drug is needed to ensure the acid is suppressed. If you are considering a trial of one of these drugs because of severe asthma, this may be an important part of the workup.

Another is the acid perfusion test, when 0.1 N hydrochloric acid is trickled into your distal esophagus to determine if your complaints of chest pain originate in the esophagus.
Both acid and a saline control are alternately infused via a nasogastric (NG) tube, without you being aware of the identity of the solution.

TESTING FOR GERD ( GORD ) BY RESPONSE TO TREATMENT- DIY

Relief by antacid is a good indication you may have gerd, BUT will not rule out nasty things like cancer of the oesophagus.

Commercial antacid mixtures are not very strong, and you may need even a small glassful. About four antacid tablets can be chewed then swallowed. A heaped teaspoon of baking soda (sodium bicarbonate) in a little warm water is another good way to test this, as long as you do not have severe kidney disease.

You may be prescribed or buy OTC a drug called a “proton pump inhibitor,” which is actually quite a good option in the short term.14

This type of drug is more effective than type 2 histamine receptor antagonists such as ranatidine, across all gradesˢᵉᵉ ᵇᵉˡᵒʷ of severity of GORD. Response to one of these drugs, is a good test and good start to treatment. 90% of severe oesophagitis with ulceration, will be healed by 8 weeks of double dose PPI treatment.

Notes for acid reflux diagnosis page

14. See The omeprazole test is as sensitive as 24-h oesophageal pH monitoring in diagnosing gastro-oesophageal reflux disease in symptomatic patients with erosive oesophagitis.
Preferably only for 1-2 weeks (see point number two in www.gastrojournal.org/article.) It is very difficult to get off these drugs if used for longer, making them a wonderful source of continued business for the pharmaceutical industry.

grade A - one or more ulcers no longer than 5mm. and not extending between the tops of two adjacent folds of the skin of the gullet.
Grade B is the same but over 5mm long.
Grade C does extend from one fold to another, but involves less than 3/4 of the circumference of your gullet.
Grade D involves more than 3/4.

The grade is not very important. It doesn't correlate well with symptom severity. The really important reason for endoscopy is seeing whether or not you have Barrett's oesophagus which is potentially pre-cancerous.


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