# GERD Testing Procedures



## JacobDO77 (Aug 6, 2015)

There are currently 4 testing procedures used the most by doctors to diagnose GERD. They are: (1) Diagnosing GERD from patient symptoms, (2) Upper GI (endoscopy) procedure, (3) BRAVO 24 to 48 hour test, (4) Heidelberg pH diagnostic test.

1. Diagnosing GERD from a patients symptoms. Diagnosing fro a patients symptoms has better than 50% chance of being wrong. This is primarily because the symptoms associated with GERD are common symptoms for three disorders. The first is *Hyper*chlorhydria, the over production of strong hydrochloric acid (HCL) in the stomach. The second condition is called *Hypo*chlorhydria, the production of weak hydrochloric acid (HCL), in the stomach. Finally the third is called Achlorhydria, the complete lack of hydrochloric acid in the stomach. This test is an In-office procedure that is relatively inexpensive.

The symptoms associated with these three conditions are: gas, reflux, belching, bloating, nausea, abdominal pain, diarrhea and/or constipation, irregular stools, etc. It is virtually impossible to make a diagnosis by just using the patients symptoms. A pH diagnostic test is absolutely necessary for making an accurate diagnosis of GERD. When a misdiagnosis occurs, because of the symptoms, a patient is usually prescribed a PPI, or acid reducing medication that can harm the body.

2. Diagnosing GERD with an Upper GI test (endoscopy). The Upper GI test is an In-Hospital procedure that requires sedation and the use of an endoscope. After being sedated, the endoscope is pushed down the patients throat into the stomach. This procedure is excellent for verifying the presence of ulcers, obstructions, polyps, and lesions. It is absolutely worthless in diagnosing digestive disorders. The endoscope can take samples of the gastric fluids, which must then be analyzed by a laboratory. This procedure cannot determine if the digestive process is working at its optimum level. The endoscopy procedure is very expensive, and has very little value in diagnosing the cause of GERD. This procedure also requires that the patient be accompanied by a friend that can driver him/her home, because of the sedation.

3. The BROVO test procedure requires the attachment of a microelectronic capsule, to the low esophagus wall, above the cardiac sphincter. This an In-Hospital procedure that requires sedation and the use of a catheter for placement. Once the capsule is attached to the esophagus wall, the information from the capsule is transmitted, to a recording device, worn by the patient. The patients wear the recording devices for 24 to 48 hours. When the test is complete the recoding device is returned to the doctor, where the information in the recorder is down loaded into a computer. The capsule can be removed from the patients esophagus in a hospital, or the small barb that hooks onto the esophagus wall degrades and allows the capsule to migrate through the digestive tract. The information from the recorder will verify the presence of GERD. In most cases the patient already knew that they had GERD to start with. This is a very expensive, invasive testing procedure.

4. The Heidelberg pH test is an In-Office procedure that does not require the use of sedation, or catheter for placement. The patient swallows a small, vitamin size, electronic pH capsule, with a sip of water. The capsule transmits the pH information found in the esophagus, stomach, small and large intestines. The information from the capsule is sent to a receiver worn by the patient. The receiver processes the information and sends it to the computer, where the information is displayed. The test usually takes less than one hour to complete and the test results are available, as soon as the test is complete. There is no discomfort to the patient during testing and the patient is relaxed and comfortable while the test is under way. A Heidelberg pH test will tell the doctor if the patient has Hypochlorhydria, Hyperchlorhydria, Achlorhydria, Pyloric insufficiency (duodenal reflux), GERD, Heavy stomach mucus (from infection or ulceration), acute or sub-acute Gastritis. The test is convenient, accurate and inexpensive.

*CONCLUSION:* Of the 4 procedures listed above, we have to give 5 stars to the Heidelberg pH test procedure. It is inexpensive, accurate, patient friendly, procedure. It is an In-office procedure that does not require sedation, or use of a catheter..


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