John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Heartburn may be obvious from the symptoms, so the doctor may not need to perform any tests or do an extensive exam.
The patient may be counseled to make lifestyle modifications and dietary changes
to begin immediately.
The doctor may order certain procedures if the diagnosis is unclear or if the prescribed medications are not relieving
the patient's heartburn.
Exams and Tests
The most common procedure is called a
(esophagogastroduodenoscopy or EGD). During this procedure the patient is lightly sedated. A special camera is placed through
the mouth and into the esophagus and stomach. The doctor can see how much damage has been done to the esophagus from stomach acid. The doctor will be able to determine and possibly treat the complications of heartburn, such as problems swallowing or bleeding.
An upper endoscopy assist the doctor in diagnosing other explanations for the pain, such as an infection.
The patient may undergo an upper GI series. In this test, the
patient drinks a liquid that coats the esophagus and stomach and shows up on
X-rays that are taken subsequently.
If an upper endoscopy shows everything is normal but the patient continues to have pain, the doctor may do further testing. This includes
a procedure to measure the weakness of the LES muscle, called an esophageal manometry.
The 24-hour pH monitoring test measures the strength of stomach
acid. A very thin tube is passed through nose into the patient's esophagus. For the next 24 hours, the test measures the amount of acid reflux that occurs while
the patient goes about his or her regular activities, including eating.
Another test uses a tiny capsule to measure acid reflux levels. The doctor uses an endoscope to attach the bean-sized capsule to
the patient's esophagus. It measures pH levels and delivers readings by radio wave to a receiver
the patient wears on the belt. After about 48 hours, the capsule detaches
and passes through the digestive system and is not recovered.
If the patient's doctor feels the patient is at risk for heart problems, additional tests may be performed to make sure
the patient's heart is healthy.