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
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 ᵡ 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.
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.