Diagnosis

Diagnosis aims to assess Reflux and exclude cancer risk (=cancer prevention). The tests include Endoscopy , Esophageal manometry and Impedance pH monitoring (= Reflux monitoring ).

Endoscopy

Sedated Endoscopy is conducted as an out patient procedure, lasts 15-20 min and examines gullet, Stomach and Duodenum . Endoscopy assesses presence or absence of inflammation in the gullet ( Esophagitis ), Stomach (gastritis), Duodenum (duodenitis). In addition the test assesses Reflux induced changes of the morphology of the esophagus, i.e. rings, webs, strictures, ulcers, polyps, tumor.
During the test the physician obtains biopsies form the Duodenum and the Stomach for the assessment of duodenitis or gastritis. Using a unique Biopsy protocol and a novel histopathology classification we assess the severity of Reflux , the size of the problem and cancer risk, i.e. Barrett‘s esophagus. The findings are cataloged within your Endoscopy report and represent the basis for your tailored therapy (life style, medical, surgical).

Endoscopy

Esophageal high resolution manometry

This out patient procedure is conducted in an upright sitting position and lasts 15-20 min. Following introduction of the spaghetti thin catheter via the locally anesthetized nose and throat the manometry catheter is placed within the esophagus. The catheter incorporates an assembly for the measurement of pressure and bidirectional fluid movement (= Impedance technology). The test assesses the competency of the lower esophageal sphincter ( Anti reflux mechanism ) and the transport function of the esophagus. Most importantly manometry excludes rare functional swallowing disorders of the esophagus ( Achalasia , distal esophageal spasm). The findings are cataloged within your manometry report and help to individually tailor the treatment of your Reflux (life style, medical, surgical). Typical findings in patients with Gastroesophageal reflux disease ( GERD ) include shortened or absent lower esophageal sphincter and impaired transport function of the esophagus.

Druckmessung/Refluxmessung

Esophageal impedance pH monitoring (Reflux monitoring)

This out patient test lasts 23-24 hrs and assesses the amount of esophageal Acid exposure , number of Reflux episodes (acidic, non acidic), correlation between Reflux and symptoms and thus examines, if Reflux is the cause for your complaints ( Heartburn , acid regurgitation, coughing, wheezing). Usually the test is started after the manometry. The spaghetti thin catheter is introduced via the nostrils and placed within the lower end of the esophagus with the pH probe 5 cm above the level of the manometric lower esophageal sphincter. The catheter is well tolerated, does not interfere with your normal daily activities and is connected to the recorder, which is fixed to a belt. During the test you should follow your normal life style. You time dependently catalog any symptom, eating and indicate changes of your body position. Fusion of these data enables the physician to assess the correlation between symptoms and Reflux . Your Reflux monitoring report includes absolute and % times of esophageal Acid exposure , number of Reflux episodes and the association between symptoms ( Heartburn , acid regurgitation, coughing, asthma) and Reflux .Typical findings in persons with Gastroesophageal reflux disease ( GERD ) include abnormal esophageal Acid exposure , increased number of Reflux episodes and a positive correlation between symptoms and Reflux events. The data of the test are used to individually tailor the treatment of your Gastroesophageal reflux disease ( GERD ).

Druckmessung/Refluxmessung


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