Medical Evaluation

Peter J. Lydon, MD, FACS
Gastroenterologists are doctors that specialize in problems of the digestive system. The tests they use to diagnose GERD are:

Barium upper GI

You swallow a chalk like drink that allows the inside of your esophagus and stomach to be seen by x-ray.

Esophagogastric duodenoscopy

A flexible scope is put into your mouth and directed through the esophagus, stomach, and duodenum. It allows the doctor to view any irritation of the lining of the esophagus and of the stomach and duodenum and how bad that irritation is. The gastroenterologist may also remove a small sample of the irritated lining (biopsy). Most patients are in a semi sleep when this is done.

High Definition Esophageal Manometry

A tube similar to the endoscope is passed down the esophagus until it reaches the stomach. You will be asked to swallow. Pressure measurements will be taken. This is how peristalsis throughout the esophagus is evaluated. The Endoscopy unit Norwood Hospital has the most up-to-date equipment required to perform and interpret this study.

Esophageal pH Study

In a conventional esophageal pH study, a thin tube is passed down your nose until the end reaches your lower esophagus. The tube stays there 24 hours during which it records how frequently acid refluxes into the esophagus and how long it stays there when it does. The SMG General Surgeons prefer a Bravo pH study where a wireless probe is placed endoscopically in the esophagus under sedation and stays in place for 48 hours before it detaches. This study is much better tolerated by the patient and gives a longer period of time to evaluate esophageal acid reflux. Both of these pH studies requires that the patient is OFF all acid reducing medication (Zantac, Prilosec, etc) for 7 to 10 days before the study. Oral antacids are allowed during this 7 to 10 days but also need to be held during the 48 hours of the study. The Endoscopy unit at Norwood Hospital, The Good Samaritan Medical Center, and Southern New England Surgery Center all have the most up-to-date equipment required to perform and interpret this study.