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Diagnosing Acid Reflux Disease

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Diagnosing Acid Reflux With Esophageal Manometry

Your doctor may perform an esophageal manometry to diagnose acid reflux. This is a test to assess your esophageal function. It also checks to see if the esophageal sphincter -- a valve between the stomach and esophagus -- is working as well as it should.

After applying a numbing agent to the inside of your nose, the doctor will ask you to remain seated. Then a narrow, flexible tube will be passed through your nose, through your esophagus, and into your stomach.

When the tube is in the correct position, the doctor will have you lay on your left side. When you do, sensors on the tube will measure the pressure being exerted at various locations inside your esophagus and stomach. To assess your esophageal functioning even further, you may be asked to take a few sips of water. The sensors on the tube will record the muscle contractions in your esophagus as the water passes down into your stomach.

The test typically takes 20 to 30 minutes.

Diagnosing Acid Reflux With Esophageal Impedance Monitoring

To obtain an even more detailed picture of how your esophagus functions, the gastroenterologist may recommend esophageal impedance monitoring. If so, this will be done in conjunction with manometry.

This test uses a manometry tube with electrodes placed at various points along its length. It measures the rate at which liquids and gases pass through your esophagus. When these results are compared with your manometry findings, your doctor will be able to assess how effectively your esophageal contractions are moving substances through your esophagus into your stomach.

Diagnosing Acid Reflux With pH Monitoring

This test uses a pH monitor to record the acidity in your esophagus over a 24-hour period.

In one version of this test, a small tube with a pH sensor on the end is passed through your nose into your lower esophagus. The tube is left in place for 24 hours with the portion exiting your nose affixed to the side of your face. It will be connected to a small recording device that you can wear or carry.

During the course of this acid reflux test, you will record in a diary when you are eating or drinking. You will also push a specific button on the recording device to indicate when you are experiencing acid reflux symptoms. This detailed information will allow the doctor to analyze and interpret your test results.

A newer, wireless version of this test is now being used. In this version a small pH sensor is affixed to your lower esophagus using suction. The small probe is able to communicate wirelessly with a recording device outside your body for 48 hours. The probe ultimately falls off and passes through the remainder of the digestive tract.

Many patients have found the wireless pH monitoring exam to be far more pleasant than the traditional version. Both techniques yield similarly information.

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WebMD Medical Reference

Reviewed by Kimball Johnson, MD on July 25, 2012
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