GERD, or gastroesophageal reflux disease, is a condition that affects up to one third of the U.S. population, with symptoms including heartburn, indigestion, regurgitation of food and drink into the chest or throat, difficulty swallowing, hoarseness and dry cough. Any of these symptoms, experienced on a semi-regular basis, warrant a trip to the gastroenterologist. GERD can potentially cause a wide spectrum of physical damage including precancerous conditions.
Diagnosing GERD
I will initially talk with my patient and ask him or her to explain the symptoms in detail. There are a number of considerations at play based on the subtleties of what the patient is experiencing.
I may order a test or procedure to help with a definitive diagnosis and proper treatment. There are a number of tests available including a Barium Test, an Upper Endoscopy and Acid Measurement.
Barium Test
An x-ray study called a barium study is the most common test. The patient swallows a substance with a paint-like consistency and a technician x-rays the patient to see where the liquid goes. Does it go all the way into the stomach and come back up into the esophagus? If so, GERD is likely. One disadvantage of this type of testing is that it doesn't give an idea of the degree of damage already present from stomach acid. Another is that it is not always accurate. A patient could have acid reflux but the mechanism might not have been triggered by the barium solution. The benefit to this test is that it is completely outpatient and does not take very long.
Upper Endoscopy
An Upper Endoscopy is also referred to as an EGD. An endoscopic examination is more complicated than a barium study. The patient first fasts and then is sedated so that I can insert an endoscope that reaches down into the esophagus. This gives me the ability to look at the esophagus in great detail, with the goal of identifying physical damage. This test can give evidence of a GERD problem, show physical deformities like scars, and discover the development of precancerous changes. An endoscopic examination allows me to intervene if there is great physical damage.
Acid Measurement
There is also a way to evaluate the ph or amount of acid moving in the wrong direction (into the esophagus from the stomach). I can place a small device in the esophagus (at the time of an Upper Endoscopy procedure) to measure the amount of acid coming up from the stomach.
If you are suffering from GERD symptoms, it's time to see a gastroenterologist to make sure no further damage occurs and to find treatment that brings relief. Make an appointment today.