I'm thinking about upper endoscopies or ambulatory oesophagal pH monitoring. I have just read on Mike Thompson's website that upper endoscopies are now very safe and only take 5-10 mins, so he would recommend one for infants with severe reflux especially if oesophagitis is a possibility.
I know there are many of us on here who had children with severe reflux - sufficient to need treating with ranitidine or omeprazole or similar drugs. I was told by one specialist who saw my ds2 that he was within the top 5% for severity. And he was on the drugs for 2 years in total. But my ds2 never had any of these investigative tests. The doses were purely based on his weight, and my reporting of his symptoms. I can't help wondering that if they had done either one of the investigations mentioned above, they would have had a more quantitative measure of how severe his reflux was, and might have taken more seriously my reports of his screaming/refusal to feed/lack of sleep etc.
Just interested to know what other parents' experiences have been in this area. (I haven't checked the NICE guidelines but I suspect they are rather fluffy if there are any at all.)