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We’ve done all those things. You’ve lost weight exercise, you have adhere to an appropriate diet, you’re taking medications to the maximum extent and you still have problems. Well then you may need to go for testing to see if number one, you have an ulcer present or growth present in your upper GI tract. But let’s say you’ve done that and there are no obvious lesions found. Then you may need to go for a different type of test. You may need to go for manometry, That’s a fancy word, but basically they’ll place a probe through your nose, down into your esophagus and the computer will determine to what degree do you have contractions in your esophageal muscles and relaxation? To what extent does that sphincter muscle that separates your esophagus from your stomach? To what degree does it contract and relax appropriately? Okay, because let’s say for example, if a patient refluxes acid but their esophagus doesn’t contract appropriately, then acid may sit there for an extended period of time. Cause more damage. Or let’s say your lower esophageal sphincter is relatively weak, the likelihood of reflux occurring is greater. Or let’s imagine you have a hiatus hernia. Now, hiatus hernia means that you have a portion of your stomach has popped up into your chest and it’s sitting there like a cup. Okay, so now when you reflux acid into this cup, the acid is sitting in this cup for a prolonged period of time. Therefore, the likelihood of the acid causing injury is greater because it can’t reflux up and come back down. It’s sitting in a cup. Alright, so these are some considerations.
