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Diagnosing Acid Reflux

How is acid reflux diagnosed?

There are several ways in which we diagnose acid reflux including:

Upper GI (gastrointestinal) series, also called a barium swallow 

This test looks at the organs of the top part of your digestive system. It checks your food pipe (esophagus), stomach and the first part of your small intestine (duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray. 

Upper endoscopy or EGD (esophagogastroduodenoscopy) 

This test looks at the lining or inside of your esophagus, stomach and duodenum. This test uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach and duodenum. This procedure allows your doctor to see the inside of these organs and take a small tissue sample (biopsy) if needed.

Bernstein test 

This test helps to see if your symptoms are caused by acid in your esophagus. The test is performed by dripping a mild acid through a tube placed in your esophagus.

Esophageal manometry

This test measures the strength and functioning of the esophagus. A thin tube is passed through the nose, down the esophagus to the beginning of the stomach. It is performed in the endoscopy suite at Florida Hospital Altamonte by a specially certified registered nurse and only takes about 15 minutes. Numbing gel is put into the nasal passage to minimize discomfort. The patient is asked to take sips of a clear liquid and swallow at various intervals. The key to success and comfort during this test is to take slow deep breaths and stay relaxed. Our nurses will be with you every moment to provide support and comfort. You can return to work or other normal activities afterwards.

pH monitoring

This test checks the pH or acid level in your esophagus. A thin, plastic tube is placed into your nostril, down your throat, and into your esophagus. The tube has a sensor that measures pH level. The other end of the tube outside your body is attached to a small monitor that records your pH levels for 24 to 48 hours. During this time you can go home and do your normal activities. You will need to keep a diary of any symptoms you feel, and also of the food you eat. Your pH readings are checked and compared to your activity for that time period.

48-hour pH bravo capsule

This test measures the acid in your esophagus at various points in your day. While performing an upper endoscopy that examines the esophagus and stomach, the physician will attach a small pill-like device on the inner lining of the esophagus.  This device will remain in the esophagus and give digital readings remotely to a special monitoring device for 48 hours.  During this time you can go home and do your normal activities. You will need to keep a diary of any symptoms you feel, and also of the food you eat. The patient is asked to maintain usual activity and meal patterns so that the probe can get an accurate picture of a typical day and send back readings of acid levels before, during and after meals and at bedtime. The probe will fall off of the lining of the esophagus after four or five days and will pass naturally through the digestive tract.

24-hour impedance pH (nasal catheter)

A thin tube is passed through the patient’s nasal passage and down the esophagus.  It remains in the esophagus for 24 hours.  The patient goes home after the tube is placed and maintains normal activity and eating.  This will measure how much acid is present in your esophagus at any given time.  The patient will return to the hospital the next day to have the tube removed, and a gastroenterologist will analyze the results.