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Diagnosis of Gastroesophageal Reflux Disease (GERD)

The doctor may suspect GER based on symptoms and medical history, like the frequency of heartburn symptoms. A trial of acid-reducing medications called proton pump inhibitors (PPIs) may also be recommended. Response to these medications can help with diagnosis.

If symptoms do not fully respond to treatment or come back frequently, GERD testing may be done.

pH Monitoring

Esophageal pH monitoring is the best way to confirm reflux. A 24-hour pH monitoring system uses a small tube that is passed through the nose or mouth, down the esophagus, and into the stomach. The tube remains in place for 24 hours and monitors the amount and frequency of stomach acid that backs into the esophagus. The doctor will review the acid report and a food and activity diary to see what is exacerbating the reflux. A second method of acid monitoring involves a small capsule that is placed in the esophagus during an endoscopy. The capsule sends information to a monitor worn outside the body. After a couple of days the capsule will break off and pass through the intestines.

Endoscopy and Biopsy

Endoscopy is a procedure that allows the doctor to closely examine the lining of the esophagus. A thin, lighted tube with a tiny camera is passed down the throat to the esophagus and stomach. The doctor will be able to see irritation or changes to the esophagus.

A biopsy may be done to look for any changes to cells. A small sample of tissue from the esophagus is removed and sent to a lab for examination by a pathologist. The biopsy can look for inflammation, cancer, or other problems.

Endoscopy

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Upper GI Series    TOP

Upper GI is a series of x-rays of the upper digestive system. A barium solution is used to help make clearer images of the esophagus. These images may show a hiatal hernia, ulcers, or an esophageal stricture.

Esophageal Manometry    TOP

Manometry can be done in a doctor's office. A specialized tube is passed through the mouth into the esophagus. The tube can measure the amount of pressure created by muscles throughout the esophagus.

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References:

Diagnosis of gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Accessed February 27, 2015.
Gastroesophageal reflux disease (GERD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 11, 2016. Accessed October 4, 2016.
Gastroesophageal reflux disease (GERD). Merck Manual Professional Version. Available at:
...(Click grey area to select URL)
Updated May 2014. Accessed February 27, 2015.
Katz PO, Gerson LB, Velva MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):302-328.
Understanding heartburn and reflux disease. American Gastroenterological Association website. Available at:
...(Click grey area to select URL)
Accessed February 27, 2015.
Last reviewed June 2016 by Daus Mahnke, MD
Last Updated: 5/20/2015

 

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