How İs İt Set?
If you have reflux symptoms (bitter water, burning) and this seriously affects your quality of life, your doctor can definitely tell you whether you have reflux with two tests. So how is stomach reflux diagnosed?
Endoscopy is the most important test to be done after listening to the patient and revealing the disturbing situation in detail.
Endoscopy
Endoscopy is performed under complete anesthesia. You don't feel anything. In endoscopy, it can be easily detected whether you have a gastric hernia or if there is an insufficiency in the valve (LES) at the junction of the esophagus and the stomach. Detection of gastric hernia or valve insufficiency alone is not sufficient.
The surest indicator of reflux is esophagitis . Esophagitis is the formation of a wound at the lower end of the esophagus due to the destruction of stomach acid in this area.
If esophagitis (wound) is not seen in the endoscopy, the 24-hour pH meter test (acid measurement test) is extremely useful in cases where the diagnosis is in between.
pH Meter Test
During endoscopy, a thin silicone catheter is inserted from your nose into your esophagus while you sleep. The tip of this catheter ends just above the valve at the lower end of your esophagus. This catheter is attached to a small device that you can wear. After the procedure, you will continue your normal life. You can eat and drink whatever you want. While you continue your daily life, the device measures acidity for 24 hours. After 24 hours, the catheter is removed and the data is analyzed. In other words, in cases where the diagnosis is in between, this test will definitely tell you whether you have acid reflux. An important point for the application of this test is if you are using a stomach acid-lowering drug, stop it at least 5 days in advance.
Apart from these two tests, it may be useful to take a film of the esophagus and apply an esophageal monometer in some patients. Occasionally, evaluation of esophageal and lower esophageal sphincter function may be required. At this point, the manometer gives extremely important information.
I would like to focus on one point in particular regarding the diagnosis of reflux disease. In the past years, reflux surgery was performed on many patients, even though they did not have reflux disease. There are certain reasons for this. I will try to explain this through examples.
Example 1: The patient goes to the otolaryngologist with problems such as burning in the throat and sound tickling. The doctor is doing his examination. He can't find anything and he says you may have reflux and refers him to a gastroenterologist or general surgeon. Endoscopy is performed without evaluating the patient very well. In the endoscopy, it is said that you have valve insufficiency and reflux surgery is applied to the patient. After the operation, the patient's complaints do not go away.
Example 2: The patient has complaints such as heartburn and bloating for a long time. Stomach protective drugs were also used, and it did not help. The patient is undergoing endoscopy. A small gastric hernia is detected and reflux surgery is performed on the patient. Of course, the patient's complaints do not go away after the surgery.
The message I want to give from these two patient examples is as follows. Reflux disease cannot be diagnosed by endoscopy alone. The patient should be evaluated thoroughly and his current complaints should be questioned well. A pH meter test should be performed in patients whose findings cannot be obtained by endoscopy.
