Medical Diagnosis of GERD

If symptoms don’t improve with lifestyle and diet changes or medication and you have persistent symptoms of reflux, your doctor may recommend testing for GERD. Your doctor may recommend you to a gastroenterologist for diagnoses and treatment options of GERD.

According to the Department of surgery of Keck school of USC, “in the United States, the prevalence range for GERD is 10% to 20% of the population (Keck School of Medicine of USC, n.d.).” The occurrence rate of GERD is also linked with age, adults aged 50 to 70 being the most affected. This rate in mixture with a longer life expectancy and aging populations is expected to increase in GERD frequencies over the years (Keck School of Medicine of USC, n.d.). GERD is one of the most common disease encountered by the gastroenterologist. A gastroenterologist as defined by the American College of Gastroenterology, is a physician with dedicated training and unique experience in the management of disease if the gastrointestinal tract and liver (American College of Gastroenterology, 2016). Gastroenterologist deal with normal functions as well as diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver.

To test for GERD, a gastroenterologist, or other trained health care professional can perform an upper gastrointestinal (GI) endoscopy and biopsy, an upper GI series, an esophageal pH and impedance monitoring. As well as a bravo wireless esophageal pH monitoring, and an esophageal manometry.

An upper gastrointestinal (GI) endoscopy is a procedure done with an endoscope- a long, flexible tube with a camera that is used to see the lining of your upper GI tract. This procedure is often done under light sedation via intravenous sedative. It can also be performed without sedation and some liquid anesthetic. Your doctor may also perform a biopsy with the endoscope. This requires taking a small piece of tissue from the lining of your esophagus. A pathologist then examines the lining tissue and sends back the results. (NIH, 2016)

An upper GI series uses an x-ray called fluoroscopy and a barium based drink to produce images of the esophagus, stomach, and small intestine. An x-ray technician will perform this procedure. Your doctor or health care professional will instruct you on how to prepare for the procedure. During the procedure, you will stand or sit in-front of an x-ray machine and drink the barium based solution. The x-ray technician will take several x-rays as the barium moves through your GI tract. This procedure will not show GERD in your esophagus, it helps find problems related to GERD such as ulcers, hiatal hernias, and esophageal strictures. (NIH, 2016)

The esophageal pH and impedance monitoring measures the amount of acid in your esophagus while you perform everyday activities such as eating and sleeping. This procedure is done by a gastroenterologist as part of an upper GI endoscopy. A gastroenterologist will pass a thin tube through your nose or mouth and into your stomach. Your gastroenterologist will pull back the tube into your esophagus and tape it to your cheek. The end of the tube that is left in your esophagus measures when and how much acid comes up to your esophagus. The other end attaches to a monitor outside the body that records the measurements. You will wear a monitor for the next 24 hours. (NIH, 2016)

The bravo wireless esophageal pH monitoring is similar to the esophageal pH and impedance monitoring in that it also measures and records the pH in your esophagus. A doctor will temporarily attach a small capsule to the wall of your esophagus during an upper endoscopy. This capsule will measure the pH levels in the esophagus and transmit information to a receiver. The receiver is similar to a pager that you will wear around your waistband or belt. Monitoring usually lasts 48 hours. (NIH, 2016)

The esophageal manometry will measure muscle contraction in your esophagus. A gastroenterologist can perform this procedure. During this procedure, a thin tube is passed through your nose, down the esophagus, and into your stomach. After the tube is in your stomach, it is pulled slowly back into your esophagus. The gastroenterologist will ask you to swallow to measure the pressure of muscle contractions. (NIH, 2016)

References (APA citation without URL):

American College of Gastroenterology. (2016). What is a Gastroenterologist? Retrieved November 22, 2016.

Keck School of Medicine of USC. Signs and symptoms of GERD acid Reflux - Los Angeles. Retrieved November 22, 2016.    

National Institute of Diabetes and Digestion and Kidney Disease. (2016, October 3). Acid Reflux (GER & GERD) in adults. Retrieved November 22, 2016.