If you’re suffering from heartburn, your doctor will probably conduct a few routine tests to diagnose the source of your heartburn discomfort and rule out any underlying cardiac problems. After pinpointing the source of your problems are reflux related, there are several options your doctor may recommend for the diagnosis and treatment of your heartburn.
Diagnostic Tests for Evaluation of Heartburn
If you’re complaining of frequent heartburn you may be suffering from symptoms of another underlying health problem. Your doctor may run a series of diagnostic tests to evaluate if your chest pain and heartburn is caused by GERD, an acid-reflux disease.
The Proton Pump Inhibitor Test
If you have non-cardiac chest pain, your doctor may have you take a proton pump inhibitor, a medication that reduces the production of acid in the stomach. After a trial period, your doctor will assess whether or not PPI treatment alleviated your symptoms. The benefit of this type of diagnostic test is that it is simple, safe, and generally cost-effective. The proton pump inhibitor test is also less invasive than other diagnostic testing methods.
If your doctor is concerned about abnormal esophageal acid exposure, or if your symptoms do not respond to PPI treatment, you may undergo 24-hour pH monitoring. This diagnostic test is also commonly used to determine if a patient is a good candidate for antireflux surgery.
To perform esophageal pH monitoring, a thin plastic tube is inserted into one nostril, down the back of the throat, and into the esophagus as you swallow. An acid sensor on the tip of the tube is positioned in the esophagus, just above the lower esophageal sphincter. The sensor records each reflux of acid that occurs over the next 24 hours and reports to a recorder that you carry with you.
This diagnostic test helps create a correlation between acid reflux and the symptoms you’re experiencing.
During an esophageal manometry, a tube is inserted into your nose and down your throat. You’re then asked to lay on your left side and swallow small amounts of water. A sensor on the tube measures how much pressure your body is exerting on the tube. The test takes 20 to 30 minutes to complete.
An esophageal manometry can help your doctor determine how well your lower esophageal sphincter, the valve that should keep acid from backflowing into your esophagus, is functioning. It can also test whether your esophagus is moving food into your stomach properly. An esophageal manometry may also be done before pH monitoring to determine where the sensor should be placed.
Possible Treatment Options For Serious Heartburn
If you have mild symptoms of heartburn or acid reflux, your doctor may suggest making simple lifestyle changes before further intervention. Some of these modifications may include elevating the head of your bed to reduce nighttime reflux, staying away from acid-inducing foods, avoiding late-night meals or snacks, and quitting smoking.
Your doctor may prescribe a medication designed to decrease your body’s production of acid. The most common and typically effective medications used in these instances are proton pump inhibitors, or PPIs. Other medications that are less commonly used to treat heartburn include histamine receptor-2 antagonists (HR2As) and smooth muscle relaxants.
Some patients will not respond to PPI therapy, or are responsive but do not wish to be on long-term medication. In these instances, antireflux surgery may be suggested as a treatment option. Currently, the two most commonly performed antireflux surgeries are Nissen fundoplication and Toupet partial fundoplication.
Talk to your doctor about which treatment for heartburn and chest pain is right for you. You’ll want to consider the severity of your symptoms, the underlying cause of your pain, and overall effects on your lifestyle.