GERD Treatment
GERD Causes
GERD Diagnosis

How is GERD diagnosed?
Lifestyle changes and medications are often the first lines of treatment for suspected GERD. If symptoms improve with these treatment methods, a GERD diagnosis often does not require testing. However, to confirm a diagnosis, a person may need testing if symptoms do not improve. People with possible GERD who have trouble swallowing also may require testing.

A completely accurate test for diagnosing GERD does not exist. However, several tests can help with diagnosis:

Bravo® pH monitoring is a catheter-free test for diagnosing GERD. A miniature pH capsule is attached to the esophagus and wirelessly transmits information to a small recorder. This method of testing collects information over several days, giving Dr. Jones the ability to evaluate the frequency and duration of reflux symptoms. Bravo® pH monitoring allows patients to go about their normal routine and maintain their normal diet during testing, which gives Dr. Jones a more accurate reading than catheter-based testing.

Esophageal pH monitoring is the most accurate test to detect acid reflux. Esophageal pH monitoring measures the amount of liquid or acid in the esophagus as the person goes about normal activities, including eating and sleeping. A gastroenterologist performs this test as a part of an upper endoscopy. The person can remain awake during the test. Sedation is not required for the test; however, it can be used if necessary.

Dr. Jones will pass a thin tube, called a nasogastric probe, through the patient’s nose or mouth to the stomach. Dr. Jones will then pull the tube back into the esophagus, where it will be taped to the person’s cheek and remain in place for 24 hours. The end of the tube in the esophagus has a small probe to measure when and how much liquid or acid comes up into the esophagus. The other end of the tube, attached to a monitor outside the body, shows the measurements taken.

This test is most useful when combined with a carefully kept diary of when, what, and how much food the person eats and GERD symptoms that result. Dr. Jones can see correlations between symptoms and certain foods or times of day. The procedure can also help show whether reflux triggers respiratory symptoms.

An Upper G.I. Series can be used to provide a look at the shape of the upper GI tract. During the procedure, the person will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the radiologist and Dr. Jones can see the organs’ shapes more clearly on x-rays. The barium shows problems related to GERD, such as hiatal hernias. While an upper G.I. series cannot detect mild irritation, the test can detect esophageal strictures—narrowing of the esophagus that can result from GERD—as well as ulcers, or sores.

Dr. Jones may use an Upper Endoscopy, also known as an esophagogastroduodenoscopy, if a person continues to have GERD symptoms despite lifestyle changes and treatment with medications. An upper endoscopy is a common test used to evaluate the severity of GERD. This procedure involves using an endoscope—a small, flexible tube with a light—to see the upper GI tract.

After the person receives sedation, Dr. Jones carefully feeds an endoscope through the mouth and down the esophagus, then into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a monitor, allowing close examination of the intestinal lining. Dr. Jones may diagnose GERD when the test shows injury to the esophagus in a person who has had moderate to severe GERD symptoms.

Esophageal manometry measures muscle contractions in the esophagus. Dr. Jones may order this test when considering a person for anti-reflux surgery. In this test, Dr. Jones passes a soft, thin tube through the patient’s nose into the stomach. The person swallows as Dr. Jones pulls the tube slowly back into the esophagus. A computer measures and records the pressure of the muscle contractions in different parts of the esophagus. The test can show if symptoms are due to a weak sphincter muscle. Dr. Jones can also use the test to diagnose other disorders of the esophagus that might have similar symptoms as heartburn. Most people can resume regular activity, eating, and medications right after the test.