Heartburn/GERD Health Center
How Is GERD Diagnosed?
How is GERD diagnosed and evaluated?
Symptoms and response to treatment (therapeutic trial)
The usual way that GERD is diagnosed-or at least suspected-is by its
characteristic symptom, heartburn. Heartburn is most frequently described as a
sub-sternal (under the middle of the chest) burning that occurs after meals and
often worsens when lying down. To confirm the diagnosis, physicians often treat
patients with medications to suppress the production of acid by the stomach. If
the heartburn then is diminished to a large extent, the diagnosis of GERD is
considered confirmed. This approach of making a diagnosis on the basis of a
response of the symptoms to treatment is commonly called a therapeutic
trial.
There are problems with this approach, however, primarily because it does not include diagnostic tests. For instance, patients who have conditions that can mimic GERD, specifically duodenal or gastric (stomach) ulcers, also can actually respond to such treatment. In this situation, if the physician assumes that the problem is GERD, he or she will not look for the cause of the ulcer disease. For example, a type of infection called Helicobacter pylori, or non-steroidal anti-inflammatory drugs (e.g., ibuprofen), can also cause ulcers and these conditions would be treated differently from GERD.
Moreover, as with any treatment, there is perhaps a 20% placebo effect, which means that 20% of patients will respond to a placebo (inactive) pill or, indeed, to any treatment. This means that 20% of patients who have causes of their symptoms other than GERD (or ulcers) will have a decrease in their symptoms after receiving the treatment for GERD. Thus, on the basis of their response to treatment (the therapeutic trial), these patients then will continue to be treated for GERD, even though they do not have GERD. What's more, the true cause of their symptoms will not be pursued further.
Endoscopy
Upper gastrointestinal endoscopy (also known as esophago-gastro-duodenoscopy or
EGD) is a common way of diagnosing GERD. EGD is a procedure in which a tube
containing an optical system for visualization is swallowed. As the tube
progresses down the gastrointestinal tract, the lining of the esophagus,
stomach, and duodenum can be examined.
The esophagus of most patients with symptoms of reflux looks normal. Therefore, in most patients, endoscopy will not help in the diagnosis of GERD. However, sometimes the lining of the esophagus appears inflamed (esophagitis). Moreover, if erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made. Endoscopy will also identify several of the complications of GERD, specifically, ulcers, strictures, and Barrett's esophagus. Biopsies also may be obtained. Finally, other problems that may be causing GERD-like symptoms-for example ulcers, inflammation, or cancers-can be diagnosed in the stomach or duodenum.
WebMD Medical Reference from MedicineNet
Important Safety Information
- KAPIDEX may not be right for everyone. You should not take KAPIDEX if you are allergic to KAPIDEX or any of its ingredients. Severe allergic reactions have been reported.
- Symptom relief does not rule out other serious stomach conditions.
- The most common side effects of KAPIDEX were diarrhea (4.8%), stomach pain (4.0%), nausea (2.9%), common cold (1.9%), vomiting (1.6%), and gas (1.6%). KAPIDEX and certain other medicines can affect each other. Before taking KAPIDEX, tell your doctor if you are taking ampicillin, atazanavir, digoxin, iron, ketoconazole, or tacrolimus. If you are taking KAPIDEX with warfarin, you may need to be monitored because serious risks could occur.
Uses of KAPIDEX
- Persistent heartburn two or more days a week, despite treatment and diet changes, could be acid reflux disease (ARD). Prescription KAPIDEX capsules are used in adults to treat heartburn related to ARD, to heal acid-related damage to the lining of the esophagus (called erosive esophagitis or EE), and to stop EE from coming back. Individual results may vary. Most damage (erosions) heals in 4–8 weeks.
Talk to your doctor or healthcare professional. Please see full Prescribing Information for KAPIDEX.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
KAPIDEX™ is a trademark of Takeda Pharmaceuticals North America, Inc., and is used under license by Takeda Pharmaceuticals America, Inc.
LPD-00767
It’s not just what you eat that can cause your stomach to churn. It’s also how much you eat and what you do after meals.
