Gastroesophageal Reflux Disease (GERD)

Extensive testing may not be needed in all people who have symptoms of gastroesophageal reflux disease (GERD). A doctor may first ask you questions about your symptoms, such as whether you have a frequent uncomfortable feeling of burning, warmth, heat, or pain just behind the breastbone, a feeling commonly referred to as heartburn. If you have frequent, severe episodes of heartburn, your doctor may prescribe medicines normally used to treat symptoms of GERD without performing any other tests. If your symptoms get better with these medicines, your doctor will usually diagnose you as having GERD.

Depending on your symptoms, your doctor may refer you to a specialist (such as a gastroenterologist) for a test called an upper gastrointestinal endoscopy. This allows your doctor to look at the inner lining of your esophagus, stomach, and the first part of your small intestine (duodenum) through a thin, flexible viewing instrument called an endoscope.

Endoscopy is used to:

• Look for problems in people who have symptoms of GERD and also trouble swallowing (dysphagia).
• Look for other causes of your symptoms if medicines have not helped.

Other tests

Sometimes endoscopy is normal but you still have symptoms that don't get better with medicine. If so, esophageal tests may be done. This testing includes:

• Manometry testing, which determines how well muscles in the esophagus move food into the stomach and how tightly the valve between the esophagus and stomach (the lower esophageal sphincter) closes. Manometry testing is also often required before doing surgery to treat GERD.
• pH monitoring, which tests how often acid from the stomach gets into the esophagus and how long it stays there.

X-ray pictures of the esophagus and stomach are not used to diagnose GERD. But they may be useful for detecting other problems that may be causing GERD symptoms, such as a hiatal hernia or a narrowing in the esophagus (stricture). These X-rays may be done as part of a series of tests called an upper gastrointestinal series.

The tests your doctor may recommend are based on your specific GERD symptoms. Before you have more GERD testing, you may want to talk to your doctor. He or she will be able to tell you what information the test is expected to provide and how the results will change your treatment.