New Endoscopic Method Diagnoses Acid Reflux
New Endoscopic Method Diagnoses Acid Reflux
Everyone experiences a little heartburn, particularly after meals. However, up to 20 million Americans suffer from daily heartburn caused by acid reflux. For some individuals, reflux is frequent or severe enough to be considered a disease called gastroesophageal reflux (GERD).
Tracia O'Shana, NP, is using new technology-wireless, ambulatory pH testing called Bravo-to discover all aspects of GERD. The esophagus, a long muscular tube that propels food from the mouth to the stomach, has a strong, ring-like muscle at the end that acts like a valve. Sometimes this muscle opens at the wrong time, allowing acidic stomach juices to splash up into the esophagus and causing heartburn. By placing a small capsule in the esophagus, O'Shana is able to record acid levels over a 48-hour period, quantify the amount of acid exposure in the lower esophagus, and correlate symptoms to the acid contact.
"We want to know how much acid is produced and how long it sits on the esophagus," explains O'Shana, who runs DHMC's Gastrointestinal Motility Laboratory. "That's really the danger sign."
Acid reflux presents symptoms such as regurgitation, difficulty swallowing, chest pain, persistent cough, sore throat, and a change in voice. Sufferers with chronic symptoms may develop Barrett esophagus, a complication of GERD that involves a change in the cells of the tissue that line the bottom of the esophagus. There is also a small but definite increased risk of cancer of the esophagus (adenocarcinoma) in people with Barrett esophagus.
Patients with GERD who need laproscopic surgical intervention or want to participate in new endoscopic methods for diagnosing acid reflux can take advantage of Bravo's wireless technology. Previous acid testing required placing a pH probe through the nose and down the esophagus for 24 hours. Patients reported discomfort and had difficulty participating in their usual activities.
"Now we have this wonderful wireless pH capsule," O'Shana says. "The Bravo capsule is attached to a catheter which is placed through the mouth and down the esophagus. The capsule is suctioned onto the esophagus for 30 seconds, deployed, and the catheter is removed."
A small device, worn outside of the body like a beeper, receives radio waves and records the information. Patients are encouraged to continue their normal activities. They are also given a diary to record particular events (like mealtimes), symptoms, or activities. O'Shana-working with Richard Rothstein, MD, chief, Section of Gastroenterology, and Maurice Kelley Jr., MD-compares recorded data to diary entries to find, for example, a correlation between physical activity and heartburn.
The technology is about a year old and new to DHMC. Patients like the simple placement procedure and ease of use. "Patients are able to carry out their daily activities and testing occurs for 48 hours instead of 24 hours," says O'Shana. "It is the greatest and latest technology for acid studies."
