In the case of recurrent symptoms, the patient should consult a physician to get the necessary medical examination and to choose the appropriate treatment tactics. When reflux disease is suspected, the counseling procedure is determined as follows: first, the family doctor examines the patient and then sends the patient to a specialist or, to make the best of it, to a reflux centre. The gastroenterologist will collect a detailed history, so that the doctor can obtain important information about the patient's current state and possibly rule out the possibility of reflux disease.
A doctor who specializes in gastroesophageal reflux disease usually performs gastroscopy and/ or pH-metry and manometry as part of the diagnostic process. At our clinic, these highly sensitive examinations are carried out in accordance with a fixed schedule and they guarantee that the patient will be diagnosed with the disease or definitively exclude it.
Gastroscopy (examination of the stomach cavity) is an important method of examination. The patient should not eat solid or liquid food within 6 hours before the medical examination. During the examination, the patient lies on his or her side under mild anesthesia. The doctor pushes the tube with the camera through the esophagus into the stomach to the duodenum. Using a gastroscope, the doctor can determine if there is reflux disease and gastric mucosa damage. A tissue biopsy is also performed during gastroscopy, which makes it possible for the pathologist to confirm or refute the diagnosis.
One more important examination is measuring pH (long-term pH-metry) right in the esophagus. During the pH measurement, a thin tube with a probe is inserted through the nose to the esophagus and into the stomach. This probe is used to measure acidity in the esophagus. Before the procedure, the patient receives a local anesthetic.
The probe is connected to a measuring device that is attached to the patient during the entire procedure. The patient must also write down all the meals and exercise during the day and night. The probe measurements and the patient's records are then evaluated by a specialist to confirm or refute the presence of reflux disease. If the pH value in the esophagus is equal to four or lower, with more than 10 per cent of measurements over the entire period, reflux disease is confirmed.