What Test Is Done to Check for Acid Reflux?

What Test Is Done to Check for Acid Reflux?

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Your doctor may have several options for diagnosing acid reflux.

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For most people, acid reflux announces itself with heartburn or regurgitation. However, the disease can cause atypical signs and symptoms, too, including chronic cough, hoarseness, chest pain, wheezing, eroded dental enamel or persistent sore throat. If you have recurrent heartburn, your doctor may be able to diagnose and treat your acid reflux without an extensive evaluation. However, if you have atypical symptoms or your diagnosis is not straightforward, your physician may order additional tests.

Acid Monitoring

While no test is 100 percent accurate for diagnosing acid reflux, measuring the acidity in your lower esophagus is considered the gold standard for establishing whether or not you have reflux. This is best achieved with pH monitoring, which entails placing a tiny probe in your esophagus -- the muscular tube connecting your throat and stomach -- to detect episodes of acid reflux. Several variations of pH monitoring are available, including those that measure acidity at several levels within your esophagus and wireless devices that can be worn for several days to determine which activities make your reflux worse.

Direct Examination

While pH monitoring is the most sensitive method for detecting acid reflux episodes, it won't tell your doctor if your acid reflux is damaging the lining of your esophagus. According to a 2013 review in "BMC Gastroenterology," endoscopy - passing a scope through your esophagus to visualize your esophagus and stomach - is the best way to detect visible signs of acid-related damage. Endoscopy is usually performed when patients are heavily sedated.

If you have a chronic cough, hoarseness, tooth damage, persistent sore throat or other extra-esophageal symptoms of acid reflux, your doctor may also order laryngoscopy. This test is similar to esophageal endoscopy and requires sedation prior to passing a scope into your throat and upper windpipe.

Detecting Stomach Enzymes

A 2012 review in "Gastroenterology & Hepatology" reported the development of a test that measures pepsin in the saliva patients who have extra-esophageal acid reflux symptoms. Pepsin is an enzyme that is only produced by the cells lining your stomach. Its presence in your saliva offers strong evidence that acidic stomach contents are rising high enough in your esophagus to mix with the secretions in your mouth. While this test may not be useful for all people with acid reflux, it could help guide therapy for those with cough, laryngitis, dental erosions or wheezing.

X-ray Studies

Prior to the widespread use of endoscopy and pH monitoring, physicians ordered barium swallows for patients who had persistent acid reflux symptoms. To perform this test, you drink a barium shake while undergoing a series of x-rays to evaluate the function of your esophagus and examine its inner architecture. While this test may still be used in certain circumstances, it is inferior to esophageal endoscopy and pH monitoring for detecting acid reflux and the complications it can cause. Your doctor will determine the best test or tests to evaluate your symptoms.