Testing Basics for Acid Reflux
Once you have tried all of the non-pharmaceutical methods for dealing with your child's GERD symptoms the doctor might suggest a trial of an acid reducing or acid blocking medication. Parents are usually told to give the medication about a week to determine if it is working. Then the child's symptoms are reevaluated. If the symptoms are gone or improved then it is likely that GERD was the cause. This is often called a "trial run" treatment and is one of the least invasive ways to determine if GERD is the problem.
If your child does not respond to a "trial run" of treatment or has additional symptoms further investigation could be warranted.
One of the first tests used in this case is called an Upper GI. During this test the child will swallow a liquid laced with barium and x-rays will be taken as the barium moves through the digestive system. While the test sounds scary the worst part is actually getting your child to drink the barium liquid in the first place. The test is NOT a definitive diagnostic tool for reflux but is a great way to rule out other structural abnormalities or problems that may contribute to reflux or cause similar symptoms.
Many doctors will also recommend a test called a pH probe. A thin tube is placed through the nose and down into the stomach. It is attached to a monitor that can be worn around the waist or carried. The probe is usually left for a period of 18-24 hours during which time you will be asked to record your child's activities and symptoms. The results will be interpreted by your child's doctor to evaluate gastroesophageal reflux and whether it is causing the symptoms.
Another frequently used test for evaluating acid reflux is called the Esophagogastroduodenoscopy (EGD). During an EGD the patient is put to sleep and a tube with a camersa is passed through the mouth and into the esophagus, stomach and upper part of the intestines. The doctor can look for structural issues, any tissue that appears to be damaged and will often take biopsy of the tissue as well. An EGD with biopsy is the only definitive test for things like Esophagitis, Eosinophillic Esophagitis (EoE) and Barrett's Esophagus. It is often ordered with complicated acid reflux that does not respond to treatment.
You can read about our experience with the EGD HERE.
I hope this blog helps you understand the basic tests used in acid reflux.