A 45-year-old lady presents with persistent reflux symptoms. The most accurate investigation in establishing diagnosis before surgical treatment includes
Endoscopy
An UGI series
Esophageal manometry
Ambulatory pH monitoring
investigations for GASTROESOPHAGEAL REFLUX DISEASE, *24 hours oesophageal pH monitoring - the gold standard. PPI should be stopped for 3 weeks prior to pH monitoring. *Barium study in head down position. * Endoscopy to exclude other disease and to assess any mucosal injury - red inflamed mucosa often with ulceration. Sliding hernia can be identified through endoscopy. When patient retches, gastric mucosa will enter the OG junction and ascends upwards to variable distance. Ref: SRB&;s manual of surgery,3 rd ed, pg no 723
G.I.T