Diagnosis & Prevention

Diagnosis of Acid Reflux (GERD)

Several tests are available to confirm GERD, they include oesophageal pH monitoring, manometry, impedance monitoring, endoscopy, biopsy and barium swallow radiograph. 

i) pH monitoring

This test measures the amount of acid reflux in the oesophagus. A catheter with a sensor tip is inserted into the oesophagus just above the LES, via the nostril and the pH reading of each reflux is recorded over a 24 to 48-hour period. Besides GERD diagnosis, the test is also used to determine the effectiveness of medications and to check if acid backflow has reached the lower throat (pharynx) and possibly the cause of cough, hoarseness and sore throat.

Oesophageal pH monitoring

ii) Manometry

Manometry is conducted to assess the oesophageal function and to determine if the LES is functioning well. A narrow and flexible tube with sensor is inserted into the oesophagus and stomach to measure the muscle contractions in the oesophagus.

iii) Impedance monitoring

Impedance monitoring provides a more detailed depiction on the functioning of the oesophagus and can be carried out in conjunction with manometry. In this procedure, a manometry tube with electrodes is placed at different points along its length to measure the rate of liquids and gases passing through the oesophagus. The effectiveness of oesophageal contractions in moving substances through the oesophagus into the stomach will be assessed against results of the manometry outcome.

iv) Endoscopy

Endoscopy is employed to examine the oesophagus for oesophagitis (inflammation of the oesophagus), esophageal narrowing and Barrett’s oesophagus, with the use of a flexible tube equipped with a light and video camera that is passed through the oesophagus.

v) Biopsy

A biopsy may be performed during the procedure of endoscopy, depending on the observation from the endoscopy. In biopsy, a tiny surgical instrument will be passed through the scope to remove a tissue sample of the oesophageal lining for assessment of any underlying disease such as oesophageal cancer.

vi) Barium swallow radiograph

Barium swallow radiograph is a special X-ray procedure performed to rule out any structural problems in the oesophagus. In this procedure, patient swallows a solution of barium to facilitate the X-rays of the oesophagus.

Barium swallow radiography

Prevention of Acid Reflux (GERD)

Acid reflux (GERD) is mostly preventable. Proper diet and a healthy lifestyle change can prevent the reflux of gastric acid into the oesophagus.

• Diet

Including the following foods into the diet can help to manage the symptoms of GERD.

1. Green leafy vegetables and other vegetables help to reduce gastric acid.

2. Ginger is anti-inflammatory and a natural remedy to ease symptoms of GERD.

3. Oatmeal absorbs acid in the stomach, other fibre options are whole grain breads and rice.

4. Non-citrus fruits such as bananas, apples and melons.

5. Low fat meats such as chicken, fish and seafood.

6. Egg white

7. Healthy unsaturated fats such as olive oil, sesame oil, sunflower oil, flaxseed and avocados. Avoid saturated and trans fats.

• Lifestyle changes

1. Lose weight, stop smoking and avoid excessive alcohol.

2. Eat smaller meals; big meals fill the stomach and exert pressure on the LES, increasing the chances of reflux.

3. Avoid eating 3 to 4 hours before bed and do not lie down for at least 3 hours after a meal. Gravity helps to prevent acid reflux from developing; lying down may cause acid to press against the LES and flows into the oesophagus.

4. Elevate the head of the bed by 6 to 8 inches, gravity helps to keep gastric acid in the stomach and lessen reflux symptoms during sleep.

5. Refrain from taking medications such as NSAIDs, sedatives, painkillers, calcium channel blockers, iron tablets and some antibiotics. Talk to your doctor if you have concerns; never stop taking a prescribed medication without first consulting your doctor.

6 Wear loose clothes. Tight clothing or belts will compress the stomach.