Investigation of Gastro-Oesophageal Reflux Disease

ALSW offers the latest in diagnostic services for GORD. Patients are evaluated, based on their symptoms, and in some cases given tests such as endoscopy (oesophagoscopy), Barium swallow, oesophageal pH and manometry.
  • Oesophagoscopy
    Using an instrument called an endoscope, we can inspect the oesophageal lining and take samples of tissue that appears abnormal. This is mandatory in older patients to exclude cancer.

  • Barium Swallow
    An X-ray test that outlines the oesophagus. It is helpful in excluding cancer or hiatus hernia and may demonstrate an oesophageal stricture.
  • Cardiac Evaluation
    Patients whose GORD symptoms include chest pain may also need an electrocardiogram (ECG) and an exercise stress test to rule out heart disease.
  • Oesophageal pH monitoring
    Oesophageal pH remains to be the 'gold standard' for diagnosis of GORD. A catheter is placed through the nose and into the oesophagus for 24 hours to measure acid concentration in the oesophagus.
  • Wireless pH monitoring
    Improves patient comfort during monitoring and allows monitoring gastroesophageal reflux over extended (i.e., 48 to 72 hours) periods of time. The information gathered by these systems is still limited to pH data only.
  • Oesophageal Manometry or Motility Studies
    Measures how tightly the LOS shuts, and determines abnormalities in oesophageal pressure and movement.
  • Combined multichannel intraluminal impedance (MII) and Ph
    MII-pH represents a change in the reflux testing paradigm. Reflux is detected by changes in intraluminal resistance determined by the presence of liquid or gas inside the oesophagus, and pH data are used to classify reflux as acid or non-acid. Combined MII-pH is the preferred method of testing patients with persistent symptoms on acid suppressive therapy, as it can clarify whether symptoms are associated with acid or non-acid reflux or not associated with reflux.