A 45 year old lady is having persistent reflux symptoms. Most accurate investigations in establishing diagnosis before surgical treatment is
GERD is often associated with hiatus hernia type IClinical featuresInvestigationsClassical traid: reterosternal burning pain, epigastric pain and regurgitation.HeaburnsRegurgitationAbdominal painCoughDysphagia for solidsBelchingBloatingManometry for measuring LES tone24 hrs PH monitoringEsophagogram TreatmentLifestyle modifications: cessation of smoking, decreased caffeine intake and avoidance of large meal at nightMedical management: double dose of PPI'SSurgical therapy: laparoscopic Nissen's fundoplication, modern fundoplication, 3600 floppy fundoplication (Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1081)
An UGI series
Endoscopy
Esophageal manometry
Ambulatory pH monitoring
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