Investigations for reflux include:

Gastroscopy

This is a form of endoscopy when an endoscope (gastroscope) is passed through the mouth and oesophagus into the stomach. A local anaesthetic throat spray is often used with or without short acting sedation to make the procedure, which lasts only 8-10 minutes, more comfortable. Gastroscopy is an excellent test for the investigation of reflux, possible hiatus hernia, dyspepsia (indigestion), when stomach ulcers are suspected or if biopsies need to be taken (e.g. duodenal biopsies to look for coeliac disease).Oesophageal physiology.

A gastroscopy is important to consider prior to endoscopic or surgical anti-reflux therapy to assess the anatomy of the oesophagus, gastro-oesophageal junction, size of any hiatus hernia (if present) and stomach.

 

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Oesophageal physiology tests

These tests are used for the investigation and measurement of severity of reflux and the assessment of oesophageal function (motility). They are important to do if endoscopic or surgical anti-reflux therapy for reflux is being considered. The tests involve passing a small inflatable balloon via a catheter into the gullet to measure the pressure and motility of the oesophagus (oesophageal manometry) which only takes a few minutes. A different type of catheter (a pH probe inserted gently through the nose) is used to measure acid levels (oesophageal pH studies) or else a special wireless capsule (the Bravo capsule) can be placed within the lower oesophagus during a gastroscopy.

PH studies usually take 24 to 48 hours to perform. Patients are able to take the equipment home with them during this time and return at the end of the test. Rather than measuring acid levels, oesophageal impedence monitoring measures whether gas or liquids reflux into the oesophagus. This is helpful for people who suffer from symptoms particularly of regurgitation which may not be acidic in nature and therefore would not be detected by a pH probe.

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Barium swallow

This is a simple x-ray procedure which involves swallowing some oral contrast agent (barium) and occasionally a marshmallow or bread bolus. It is useful for the investigation and assessment of reflux, hiatus hernia and dysphagia (difficulty swallowing).

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