Diagnosing GERD
To help decide if you have GERD, your health care provider will ask you to
describe the type of symptoms you have, their severity, their frequency (how
many times per week), and how long the symptoms last. The most common symptoms
of GERD include heartburn and acid regurgitation (reflux), in which stomach
acid backs up into the mouth. These symptoms are often made worse by bending
over, stooping or lying flat. If you have had partial or temporary relief with
over-the-counter medicines, let your doctor know.
Your doctor may begin by suggesting lifestyle modifications and provide a trial
of an appropriate medicine for your situation. If your symptoms improve based
on treatment, a diagnosis of GERD may be made.8 If the treatment is
effective, your doctor may not order any additional tests.
If you do not get relief from the trial or treatment, your doctor may order
testing. Testing is also done for patients who have what are called “alarm
symptoms.” Alarm symptoms include weight loss, anemia, bleeding from your
gastrointestinal tract (either vomiting blood or having blood in your bowel
movements), difficulty swallowing or pain on swallowing.8
The test ordered depends on the type and severity of symptoms. Diagnostic tests
that might be used include:
Endoscopy tests are performed to see if the esophagus has been damaged. A
thin, bendable tube with a video camera is put into the mouth and passed down
the esophagus into the stomach. The doctor uses this tool to identify injured
areas in the esophagus. Patients are typically sedated during this outpatient
treatment.
Barium Esophagram is a test that looks for changes in the shape of the
esophagus and may see abnormalities in the lining of the esophagus, as well as
reflux of the barium during the test. The shape of the stomach can also be seen
using this test.4 The patient drinks a chalky liquid that contains
barium. The barium coats the esophagus and stomach. A doctor can then see the
outline of the esophagus and stomach on an x-ray.
Esophageal pH Monitoring is used to find out the severity of acid reflux.
It tests for the amount of acid in the esophagus over time.4 It can
also tell how long acid stays in the esophagus. There are two different forms
of this test. In the first, a tiny tube is inserted through the nose and down
the esophagus. There is a small acid monitor at the end of the tube that
measures acid levels for 24 hours. In the second, which requires an endoscopy,
a monitor the size of a medicine capsule can be attached to the esophagus
during endoscopy. It stays in the esophagus and tests for acid over time. After
about 48 hours, the monitor is passed out of the body as if it were a piece of
food.9