Struggling with symptoms of reflux? Getting the right diagnosis is the first step to managing and treating this common problem
Reflux, also known as acid reflux or gastro-oesophageal reflux disease (GORD), affects many people. It is estimated that up to one in four UK adults suffer from the often uncomfortable and sometimes painful symptoms that accompany it. However, there is no need to suffer in silence.
If you’re experiencing symptoms, such as heartburn, burping, bloating or regurgitation, it’s important to seek support from your healthcare provider and get a diagnosis. This can help you to understand and manage your symptoms, and find the most effective treatment for you.
At The Functional Gut Clinic, we offer diagnostic testing to get to the bottom of your reflux.
What actually is reflux?
Reflux occurs when the contents of your stomach flows back into your oesophagus, also known as your food pipe. Typically, food and drink should only flow one way down the food pipe and into the stomach. The lower oesophageal sphincter, which is essentially a muscular ring, stops food from flowing back up the pipe. However, when this isn’t working properly, food can travel back up the pipe, along with stomach acid. This acid can lead to heartburn and other common symptoms, along with inflammation in the oesophagus.
Symptoms of reflux
Common symptoms that suggest you may be suffering from reflux include heartburn, indigestion, burping, bloating, nausea and trouble swallowing.
We know how frustrating it can be when you’re unsure what might be causing your troublesome symptoms. If you think you might be suffering from acid reflux, we recommend booking an appointment with your GP or healthcare provider, who can refer you for diagnostic tests with us at The Functional Gut Clinic.
Diagnosing acid reflux at The Functional Gut Clinic
At The Functional Gut Clinic, we offer two main diagnostic tests for reflux: 24-Hour Reflux Testing and Oesophageal Manometry testing
1. Oesophageal Manometry
Your doctor may refer you for an Oesophageal Manometry test if you’re having chest discomfort and/or difficulty or pain while swallowing. This test measures the function of the oesophagus and lower oesophageal sphincter, assessing how your oesophagus works when you swallow.
It could be that there is a problem with the sphincter muscle holding the bottom of the food pipe shut, or it could be an indication of underlying health problems.
For this test, a very fine tube is gently inserted through your nose so it bypasses the gag reflex. It is a paediatric tube that is also used on small children. This goes slowly down the back of your throat into your oesophagus and stomach. The tube is then taped to your nose to keep it in place. This is painless, however it may feel like a slightly odd sensation. If you have any concerns about sensitivity, an anaesthetic spray can be applied to your nose beforehand.
During the 10-minute test, you will be asked to take sips and swallows of slightly salty water and some food. This allows us to see how the muscles are functioning. Recordings of oesophageal pressures will be made throughout the test before the tube is removed.
Oesophageal Manometry testing is often performed in combination with our 24-Hour Reflux Testing.
2. 24-Hour Reflux Testing
As the name suggests, 24-Hour Reflux Testing measures pH and impedance over 24 hours, which allows us to measure both acidic and non-acidic reflux. This allows us to determine a possible cause for your symptoms.
Similar to the Oesophageal Manometry, this test involves inserting a fine tube into your nose, down your oesophagus and into your stomach. This is painless, however a topical anaesthetic can be applied to your nose to make this more comfortable. A recording device is attached to the catheter, which is fixed to a long strap. This is to be taken home and worn over your shoulder or across your body as you go about your day as usual.
To ensure you get the best, most accurate results from your 24-Hour Reflux Test, follow the instructions given to you by your physiologist. They will explain how the recorder works and tell you which buttons to press and when.
After 24-hours, the tube is removed, either by yourself or in the clinic. The recording device will then be returned to us using a freepost envelope or in-person.
Following both these tests, your data will be analysed and written up into a report, along with advice regarding the next steps. This will then be sent to you and your doctor or consultant.
Other ways to diagnose reflux
There are also some other tests that can help with diagnosing reflux:
1. Endoscopy (OGD)
An endoscopy (OGD) is a medical procedure that works by inserting a thin, flexible tube (called an endoscope) through the mouth, down the oesophagus and into the stomach. The endoscope is fitted with a light and camera, which provides insight into any abnormalities along the oesophagus.
2. Barium Swallow and Barium Meal Test
The Barium Swallow and Barium Meal Test are non-invasive tests. They both involve swallowing food or liquid containing a substance called barium, which is a substance that shows up on X-rays. As the barium makes its way down the oesophagus, x-rays are taken to examine the oesophagus and pinpoint any issues or blockages.
3. BRAVO Study
Another option for diagnosing reflux is the BRAVO Study, which assesses the amount of acid which enters your oesophagus over a period of time – typically 48 to 96 hours. For this, a small Bravo capsule is temporarily placed on the lining of the oesophagus during an upper endoscopy. Once in place, the capsule can measure the pH levels of the oesophagus and report back wirelessly. After the test, within four to 10 days, this disposable capsule will naturally pass into the toilet and can be flushed. Throughout this time period, you’ll be asked to keep a diary of your food and drink intake, as well as your symptoms and positional changes or periods of sleep.
Are you experiencing reflux symptoms?
These diagnostic tests are pivotal in identifying reflux and working out the best treatment for you, as well as the necessary lifestyle changes, which can ease symptoms and help you live more comfortably.
If you are suffering with symptoms and suspect you may have acid reflux, contact your GP for a referral to a gastroenterologist or other relevant healthcare professional. Your consultant can then refer you to us for fast and accurate diagnostic testing to inform and support your treatment.