sheeezooo
Forum Guru
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65y/o lady..with daily heart burn for 3 months..fail to respond to trial of PPI therapy.upper endoscopy done her esophageal mucosa is normal..most appropriate diagnostic procedure is?
1.endoscopic biopsy of esophageal mucosa
2.esohageal motility
3.24 hr ambulatory esophageal PH
4.esophagography
5.double the dose of PPI.
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| som
Forum Guru
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5? but tht doesn't look like diagnostic procedure
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| nadiabarati
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2?
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| Sea_gull
Forum Elite
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choice "3"
24hr ambulatory esophageal pH
GL
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| shalu
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i choose 3.
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| study_ing
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id vote for 3 too.
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| saadtazjam
Forum Elite
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pls explain the reasoning behind it.I go For 2 as i think endoscopy shows normal mucosa hence no reflux then i think it is esophageal spasm hence 2.Correct me if i am wrong-thanks
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| saadtazjam
Forum Elite
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cud be 1.Long standing GERD-Barrets Esophagus---
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| sheena2005
Forum Elite
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3
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| sheena2005
Forum Elite
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what is the correct answer for this one?
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| tolito
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3
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| sheeezooo
Forum Guru
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 3 is the answer...note that upper endoscopy had been normal..random biopsies are rarely of value.in the abscence of true gold standard of gastroesophageal reflux disease ,24 hr PH monitor which measure acid reflux and symptoms is the best method of corelating symptoms to acid exposure in the esophagus.
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if u hold up your head with a smile on your face and are truely thankful,u are blessed because the majority can, but most do not..
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| cbenitesch
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yup
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| sheena2005
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kool
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