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The
common techniques to properly diagnose Reflux are as follows:
A) History and physical examination.
B) Transnasal Flexible Laryngoscopy
(TFL)- A way of examining the larynx and throat with a thin, flexible endoscope
that is passed via the nose which permits a magnified view of the laryngeal structures
and functions. Patients with LPR have distinct physical examination findings such
as swelling, or edema, of the laryngeal tissues (allow reader to go to image gallery
under reflux disease) and often changes in the appearance of the vocal folds themselves
(allow reader to go to image gallery under reflux disease).
C) Laryngeal
Sensory Testing- Recent work is demonstrating that sensory testing can be added
to TFL in order to make a diagnosis of acid reflux disease. Sensory testing involves
administration of a discrete pulse of air via a port, or opening, in a transnasally
placed, thin, flexible endoscope, in order to elicit an airway protective reflex.
One can imagine that if acid injury has caused swelling of laryngeal tissues,
the strength of the air pulse required to elicit the laryngeal adductor reflex
(the airway protective reflex) would be greater in patients with acid-induced
laryngeal swelling. Therefore, in patients without neurological disease (neurological
disease alone (Parkinson's; ALS; Stroke) can cause sensory deficits) sensory deficits
determined by laryngeal sensory testing can indicate acid reflux disease.
D) 24 hour pH testing- A probe is placed transnasally into the esophagus
and pH changes that take place in various areas of the esophagus are recorded
to a transmitter the patient wears or keeps nearby.
E) Barium Swallow
(barium esophagography or esophagram)- An X-ray test of the esophagus where barium
is swallowed an X-rays are then taken as the barium descends from the mouth to
the throat to the esophagus inot the stomach. It is the esophageal portion of
the well known X-ray test called an upper GI series.
F) Esophagoscopy
(examining the esophagus endoscopically) - Examining the esophagus endoscopically.
This can be performed with a rigid scope via the mouth under general anesthesia
in the operating room, with a large flexible scope via the mouth under conscious
(intravenous sedation) in an endoscopy suite, or with a thin, flexible scope via
the nose under topical anesthesia in the office.
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Diagnosis
