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.
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.