GERD can lead to many
complications if left untreated, including: esophagitis, esophageal
stricture (narrowing) and ulceration, Barrett’s Esophagus (a
pre-cancerous condition), esophageal cancer, pneumonia, lung abscess
and pulmonary fibrosis.
Accurate diagnosis is
critical if an appropriate treatment plan is to be developed.
Twenty-four hour pH (acid level) study of the esophagus is the gold
standard in the diagnosis of GERD. By placement of a small
monitoring tube in the esophagus, the frequency and duration of
reflux episodes can be measured as the patient does their daily
routine. The patient records when symptoms occur; this can then be
correlated with the pH recordings.
Upper endoscopy is
invaluable in the diagnosis of GERD as it identifies inflammation of
the esophagus caused by the condition. It also allows the
endoscopist to biopsy any area which is suspicious of Barrett’s
Esophagus or cancer.
Esophageal Manometry
(measurement of pressure) is very useful in ruling out motility
disorders of the esophagus such as achalasia, scleroderma or diffuse
spasm. The treatment of these disorders is much different than that
of GERD and it is essential to diagnose them precisely. An Upper GI
Barium test allows us to define an abnormal anatomy such as a hiatal
hernia which significantly contributes to GERD.
