Acid Reflux Symptoms and Diagnosis
Acid reflux is first suspected when its hallmark symptom, heartburn, crops up. The sub-symptoms of heartburn include: a burning sensation just beneath the middle of your chest after meals that increases in severity when you are down; belching; trouble swallowing; a sour taste in your mouth; a chronic dry cough; a sore throat; and wheezing. Besides heartburn and its sub-symptoms, other general symptoms of acid reflux include: a hoarse voice when you first wake up, the feeling that something is stuck in your throat, the sensation of choking, and foul or bitter-smelling breath.
When a patient is experiencing these symptoms, the patient’s doctor will treat him or her with a medicine that reduces stomach acid production. The doctor prescribes this medication not only to make the patient more comfortable, but also because he or she is trying to confirm or rule out acid reflux as a diagnosis. If your heartburn is indeed mitigated by this prescription medication, the doctor will consider his or her diagnosis of acid reflux confirmed. This method of diagnosis, which focuses on how symptoms respond to medicinal treatment, is called a therapeutic trial.
If a therapeutic trial does not prove effective in pinpointing a diagnosis, or your doctor feels the need to rule out other conditions with symptoms that mimic those of acid reflux, such as duodenal or gastric ulcers, he or she may recommend a specialist or perform other diagnostic tests. One such diagnostic test is called an upper gastrointestinal endoscopy, which is also known as esophago-gastroduodenoscopy or EGD. Before the EGD came along, X-rays were used to view a patient’s esophagus. These esophageal X-rays, called esophagrams, was not very accurate in diagnosing acid reflux because they could only pick up on the rare and severe symptoms, like ulcers and strictures.
In the case of the more modern EGD, the patient swallows a tube that houses an optical visualization system, which allows the doctor to view the gastrointestinal tact as well as the lining of your esophagus, your stomach, and your duodenum (the small intestine that attaches to your stomach). An upper gastrointestinal endoscopy is not always effective in diagnosing acid reflux since the lining of the esophagus of many acid reflux patients is not visibly inflamed. However, an EGD is particularly useful in identifying erosions to or ulcers in the esophageal lining, as well as any resulting complications like strictures, ulcers, and Barrett’s esophagus.
Biopsies of the esophagus are sometimes taken by endoscopy in order to rule out cancers and other infectious illnesses that may cause the esophageal lining to become inflamed. Biopsies can help identify cell mutations indicative of diseases like Barrett’s esophagus, but they are not particularly helpful in diagnosing acid reflux specifically.
There are four other high-tech diagnostic tests available for acid reflux and related diseases or complications. These are: esophageal acid testing via a Ph test, esophageal motility testing to evaluate symptoms that do not respond to treatment, gastric emptying studies that tell how successfully food empties out of the stomach, and an acid perfusion test that uses a salt solution to induce acid reflux.
If you’re suffering from acid reflux symptoms, you primary care physician may refer you to an ear, nose, and throat specialist. The EMT would then examine your throat and larynx to make sure there is no significant damage to either.