Assessment of gastrooesophageal reflux

Tests to prove gastro-oesophageal reflux

Ambulatory pH monitoring, using glass or antimony electrodes with either combined or external reference electrodes. For a 24-hour monitoring period, the exposure of oesophageal mucosa to a pH less than 4 for more than 5% of the duration of the test indicates pathological acid reflux.

Barium swallow (air-contrast or double-contrast).

Scintigraphy, which usually involves the use of 99Tc m and gamma camera scanning.

Oesophageal manometry. This is achieved with a multi-lumen, low-compliance, water-perfused catheter with radially oriented orifices at multiple positions along the catheter. This allows the recording of pressure at each position and the tracking of peristaltic waves from the pharynx to the lower oesophageal sphincter. The information obtained includes oesophageal motility, along with length, resting pressure, ability to relax, and location in relation to the diaphragm of the lower oesophageal sphincter. Gastro-oesophageal reflux is evidenced by low basal lower oesophageal sphincter tone, with complete relaxation following a successful wet swallow.

Tests to prove oesophagitis

Barium swallow

Oesophagoscopy with biopsy

Acid perfusion tests

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