In most of the case the acid reflux or gastroesophageal reflux are diagnosed based on the clinical presentation. Generally, the medical history of the child as told by his/her parents is enough for a pediatrician to diagnosis acid reflux. Especially if some common symptoms like spit up or vomiting is shown. Sometimes even after detecting acid reflux the pediatrician may suggest only to change food habit or position change while feeding. When home remedies for acid reflux fails, then proper diagonosis of acid reflux is extremely necessary. However if the symptoms are atypical and some major symptoms are seen. Then pediatrician will suggest some tests.
Methods use for diagnosis of acid reflux in infants
There is no exact test to detect gastroesophageal reflux. Some common test may help diagnosis of acid reflux. That are divided into two categories:
Radiologic studies include the following test methods:
- Upper gastrointestinal imaging series
- Gastric scintiscan study
Physiologic and electrophysiologic studies
The following testing methods are well known to diagnosis of acid reflux:
- Intraesophageal pH probe monitoring
- Intraluminal esophageal electrical impedance
Upper gastrointestinal imaging series: Upper gastrointestinal imaging series is a safe way for detection of reflux by X-ray. Although, most pediatrician doesn’t use this test for detection of reflux. The upper Gl. series perform an important role to look at the shape of upper Gl. track.
During this test, it is suggested that the stomach of the infant remain empty before testing. Doctor usually tell his/her parents to monitor this condition. Then the infant usually rest under an X-ray machine and he/she is given to drink barium liquid usually white colored. Then to detect the effect of drinking the liquid the technician or radiologist may press the abdomen of the infant or change position. X-ray video called fluoroscopy is used to see movement of barium liquid through the esophagus, stomach and duodenum. Then the image is interpreted by an image specialist doctor.
Gastric scintiscan study: This test is also useful for diagnosis of acid reflux. The first step involve in this process is that, the patient is given to drink milk or eat food with a little mix of radioactive chemical (e.g. technetium sulfur colloid). This chemical is followed using a special camera.
An error in performing scintigraphy is that not repetition of a delayed scan over the pulmonary bed. Acid reflux aspiration may occur as an early or late postprandial (happening after dinner and lunch) phenomenon.
Esophagography: Diagnosis of acid reflux for a mild case, is made by clinical assessment and confirmed depending on response to therapy. This is usually done to see the condition of esophagus. However it should not be used to assess the severity of acid reflux.
Intraesophageal pH probe monitoring: pH monitoring has become a widely overuse test system, it remains the criterion to diagnosis of acid reflux.
When the test is conducted the infant is asked to swallow, a thin tube with a probe at the tip will stay in the esophagus for 24 hours. The tip is positioned at the lower part of the esophagus. It also helps to determine the breathing problem, if the problem is associated with acid reflux.
Intraluminal esophageal electrical impedance (EEI): In 1991 Silny described an approach for EEI on the basis of multiple electrical impedance measurements. It is useful to detect acid reflux and also nonacid reflux by measuring retrograde flow in the esophagus. It is still not validated and most of the case used for adults.
After the diagnosis doctors will suggest treatments of acid reflux for your baby. It is necessary to start the treatment immediately.