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Page: Diagnosis
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A detailed history taking is vital to the diagnosis. Useful investigations may include barium swallow X-rays, esophageal manometry, 24 hour esophageal pH monitoring and Esophagogastroduodenoscopy (EGD). In general, an EGD is done when the patient does not respond well to treatment, or has alarm symptoms including: dysphagia, anemia, blood in the stool (detected chemically), wheezing, weight loss, or changes in the voice. Some physicians advocate once-in-a-lifetime endoscopy for patients with longstanding GERD, to evaluate for the presence of Barrett's esophagus, a precursor lesion for esophageal adenocarcinoma.
Esophagogastroduodenoscopy (EGD) (a form of endoscopy) involves the insertion of a thin scope through the mouth and throat into the esophagus and stomach (often while the patient is sedated) in order to assess the internal surface of the esophagus, stomach and duodenum.
Biopsies can be performed during gastroscopy and these may show:
* Edema and basal hyperplasia (non-specific inflammatory changes)
* Lymphocytic inflammation (non-specific)
* Neutrophilic inflammation (usually due to reflux or Helicobacter gastritis)
* Eosinophilic inflammation (usually due to reflux)
* Goblet cell intestinal metaplasia or Barretts esophagus.
* Elongation of the papillae
* Thinning of the squamous cell layer
* Dysplasia or pre-cancer.
* Carcinoma.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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