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==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Ambulatory pH Monitoring===
 
A probe can be placed via the nose into the esophagus to record the level of [[acidity]] in the lower esophagusBecause some degree of variation in acidity is normal, and small reflux events are relatively common, such monitors must be left in place for at least a 24-hour period to confirm the diagnosis of [[Gastroesophageal_reflux_disease|GERD]]The test is particularly useful when the patient's symptoms can be correlated to episodes of increased esophageal acidity.
 
==Overview==
Other diagnostic findings present in [[heartburn]] and consistent with diagnosis of [[gastroesophageal reflux disease]] ([[GERD]]) is the presence of acidic reflux in [[Esophagus|the esophagus]] through the ambulatory [[reflux]] monitoring.
 
==Other diagnostic studies==
===Ambulatory reflux monitoring===
* GERD is mostly diagnosed clinically by the presenting typical symptoms which include [[heartburn]], [[regurgitation]], and [[dysphagia]].
* Correlation of the GERD symptoms with confirmed [[acid]] presence by the ambulatory [[reflux]] monitoring is strongly suggestive of GERD.
* Ambulatory reflux monitoring is recommended by the American College of Gastroenterology (ACG) as the only laboratory test to determine the presence of acidic reflux in [[Esophagus|the esophagus]].<ref name="pmid23419381">{{cite journal| author=Katz PO, Gerson LB, Vela MF| title=Guidelines for the diagnosis and management of gastroesophageal reflux disease. | journal=Am J Gastroenterol | year= 2013 | volume= 108 | issue= 3 | pages= 308-28; quiz 329 | pmid=23419381 | doi=10.1038/ajg.2012.444 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23419381 }}</ref>
* Indications of ambulatory reflux monitoring include the following:<ref name="pmid234193812">{{cite journal| author=Katz PO, Gerson LB, Vela MF| title=Guidelines for the diagnosis and management of gastroesophageal reflux disease. | journal=Am J Gastroenterol | year= 2013 | volume= 108 | issue= 3 | pages= 308-28; quiz 329 | pmid=23419381 | doi=10.1038/ajg.2012.444 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23419381 }}</ref>
** GERD diagnosis if it is not confirmed
** Determine the time of reflux occurrence
** Refractory GERD symptoms  
** Preoperative for non-erosive disease
* Ambulatory reflux monitoring is performed in either two ways which include:
** Telemetry capsule (48 hours monitoring)
** Transnasal catheter (24 hours monitoring)
 
===Upper Gastrointestinal (GI) Series===
===Upper Gastrointestinal (GI) Series===
A series of x-rays of the upper digestive system are taken after drinking a [[barium]] solution.  These can demonstrate reflux of barium into the esophagus, which suggests the possibility of gastroesophageal reflux disease.  More accurately, [[fluoroscopy]] can be used to document reflux in real-time.
A series of x-rays of the upper digestive system are taken after drinking a [[barium]] solution.  These can demonstrate reflux of barium into the esophagus, which suggests the possibility of gastroesophageal reflux disease.  More accurately, [[fluoroscopy]] can be used to document reflux in real-time.
===Biopsy===  
===Biopsy===  
A small sample of tissue from the esophagus is removed. It is then studied to check for inflammation, cancer, or other problems.
A small sample of tissue from the esophagus is removed. It is then studied to check for inflammation, cancer, or other diseases.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Revision as of 18:04, 4 September 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] José Eduardo Riceto Loyola Junior, M.D.[3]

Other Diagnostic Studies

Overview

Other diagnostic findings present in heartburn and consistent with diagnosis of gastroesophageal reflux disease (GERD) is the presence of acidic reflux in the esophagus through the ambulatory reflux monitoring.

Other diagnostic studies

Ambulatory reflux monitoring

  • GERD is mostly diagnosed clinically by the presenting typical symptoms which include heartburn, regurgitation, and dysphagia.
  • Correlation of the GERD symptoms with confirmed acid presence by the ambulatory reflux monitoring is strongly suggestive of GERD.
  • Ambulatory reflux monitoring is recommended by the American College of Gastroenterology (ACG) as the only laboratory test to determine the presence of acidic reflux in the esophagus.[1]
  • Indications of ambulatory reflux monitoring include the following:[2]
    • GERD diagnosis if it is not confirmed
    • Determine the time of reflux occurrence
    • Refractory GERD symptoms
    • Preoperative for non-erosive disease
  • Ambulatory reflux monitoring is performed in either two ways which include:
    • Telemetry capsule (48 hours monitoring)
    • Transnasal catheter (24 hours monitoring)

Upper Gastrointestinal (GI) Series

A series of x-rays of the upper digestive system are taken after drinking a barium solution. These can demonstrate reflux of barium into the esophagus, which suggests the possibility of gastroesophageal reflux disease. More accurately, fluoroscopy can be used to document reflux in real-time.

Biopsy

A small sample of tissue from the esophagus is removed. It is then studied to check for inflammation, cancer, or other diseases.

References

  1. Katz PO, Gerson LB, Vela MF (2013). "Guidelines for the diagnosis and management of gastroesophageal reflux disease". Am J Gastroenterol. 108 (3): 308–28, quiz 329. doi:10.1038/ajg.2012.444. PMID 23419381.
  2. Katz PO, Gerson LB, Vela MF (2013). "Guidelines for the diagnosis and management of gastroesophageal reflux disease". Am J Gastroenterol. 108 (3): 308–28, quiz 329. doi:10.1038/ajg.2012.444. PMID 23419381.