Acid reflux occurs when stomach contents, including stomach acid, flow backward into the esophagus. This happens due to a relaxation or weakening of the lower esophageal sphincter, a muscle acting as a valve between the esophagus and the stomach. While many individuals experience occasional acid reflux, persistent or frequent episodes can signal a more significant condition known as gastroesophageal reflux disease (GERD).
When to Seek Medical Advice
Occasional acid reflux, often characterized by a burning sensation in the chest known as heartburn, can be common. However, if symptoms become frequent, occurring more than twice a week for several weeks, it may indicate gastroesophageal reflux disease (GERD). Other common symptoms include regurgitation, the sensation of sour or bitter-tasting acid backing up into the throat or mouth, and chest pain. Some individuals may also experience difficulty swallowing, a chronic cough, or hoarseness.
It is important to seek medical advice if you experience persistent symptoms or if they become severe. Alarm symptoms that require prompt medical evaluation include unintended weight loss, severe pain, or any signs of bleeding, such as blood in vomit or black, tarry stools. These indicators suggest potential complications. Professional medical evaluation is necessary to avoid delaying the identification of underlying issues.
Initial Doctor’s Consultation
During an initial consultation for suspected acid reflux, your general practitioner or family doctor will gather a comprehensive medical history. They will likely ask detailed questions about your symptoms, including their frequency, severity, and any specific triggers you have noticed. Information about your lifestyle, diet, and current medications will also be relevant to help understand potential contributing factors.
A physical examination may also be part of this visit, allowing the doctor to assess your overall health and look for any external signs related to your symptoms. Based on this initial assessment, your doctor might recommend starting with certain lifestyle modifications, such as dietary adjustments, or suggest a trial of over-the-counter medications. If symptoms persist or if there are concerns about potential complications, your doctor may then refer you for further specialized evaluation or diagnostic tests.
Common Diagnostic Procedures
If initial treatments and assessments do not fully clarify the cause of your symptoms, a healthcare provider may order specific diagnostic procedures.
Upper Endoscopy (EGD)
An Upper Endoscopy, also known as EsophagoGastroDuodenoscopy (EGD), involves inserting a thin, flexible tube with a camera through the mouth to visualize the lining of the esophagus, stomach, and the first part of the small intestine. This allows the doctor to check for inflammation, ulcers, or structural changes like Barrett’s esophagus, which is a precancerous condition. Biopsies can also be taken during an EGD for microscopic examination.
Esophageal pH Monitoring
Esophageal pH Monitoring measures the amount of acid exposure in the esophagus and correlates it with reported symptoms. This can be done using a thin catheter inserted through the nose and left in place for 24 hours, or with a wireless capsule temporarily attached to the esophageal lining. The data collected helps determine how often and for how long stomach acid enters the esophagus, providing objective evidence of reflux episodes.
Esophageal Manometry
Esophageal Manometry evaluates the function of the esophageal muscles and the lower esophageal sphincter. A thin, pressure-sensitive catheter is passed through the nose into the esophagus to measure the strength and coordination of muscle contractions when swallowing, as well as the pressure within the esophageal sphincters. This test helps identify issues such as a weakened lower esophageal sphincter or problems with the esophagus’s ability to clear acid.
Barium Swallow (Upper GI Series)
A Barium Swallow, or Upper GI Series, involves drinking a liquid containing barium, which coats the lining of the upper digestive tract. X-ray images are then taken as the barium passes through the esophagus, stomach, and small intestine. This procedure helps visualize the structure of these organs, allowing for the detection of conditions like esophageal strictures or a hiatal hernia.
Confirming Your Diagnosis
Following diagnostic procedures, your doctor will synthesize the information from your symptom history, physical examination, and test results. This comprehensive review enables them to make an informed diagnosis, such as gastroesophageal reflux disease (GERD). A confirmed diagnosis provides a clear understanding of the underlying cause of your symptoms. It also helps differentiate GERD from other conditions that may present with similar symptoms, ensuring appropriate management.