GERD Testing and Diagnosis – Healthline

GERD, or gastroesophageal reflux disease, is a digestive disorder in which you experience frequent bouts of acid reflux. Acid reflux is the backward flow of stomach fluids into your esophagus. Your doctor can use a GERD test to determine if you have this condition.
There are various types of tests used to diagnose GERD. The best option depends on your symptoms.
Read on to learn about the different GERD tests and when each one is usually used.
The most common GERD symptom is heartburn. It involves a burning feeling in the chest, which is due to acid reflux into the esophagus. This burning sensation might also spread toward your throat.
GERD also commonly causes regurgitation or the backup of stomach contents into your throat or mouth. This can cause an unpleasant sour or bitter taste.
Other possible GERD symptoms include:
It’s important to note that GERD symptoms can differ from one person to the next. For example, some people may not experience heartburn or regurgitation, even though these are the most common symptoms.
There are different types of tests used to diagnose GERD. The best option depends on your symptoms and how severe your symptoms are.
Your doctor can determine which test is right for you. The main diagnostic GERD tests include:
GERD can damage the upper digestive tract. This includes your:
Because of this, your doctor may want to check the lining of these areas using an esophagogastroduodenoscopy (EGD). This is the most common GERD test. It’s also known as an upper gastrointestinal (GI) endoscopy.
The test uses an endoscope, or a camera attached to a flexible tube and light. The tube is inserted into your mouth and through your upper digestive tract.
This allows your doctor to examine the lining of your esophagus and look for signs of GERD.
If you have GERD symptoms but have a normal endoscopy, your doctor might recommend ambulatory pH monitoring. This is the most accurate GERD test, making it the “gold standard” for GERD diagnosis.
It involves a pH-measuring device, like a catheter or wireless capsule. The device is placed in your esophagus for 24 to 48 hours.
During this time, the device measures the pH of your esophagus. pH measures how acidic or alkaline (basic) something is. It also measures the frequency, severity, and duration of acid reflux.
If your esophagus is frequently acidic during the 24 to 48 hours, you’ll be diagnosed with GERD.
An esophageal impedance pH study is similar to ambulatory pH monitoring.
In this test, a flexible tube is inserted into your esophagus through your nose for 24 hours. It measures the movement of liquid from your stomach and into the esophagus.
Your doctor might recommend this test if your ambulatory pH monitoring is normal. Additionally, both the esophageal impedance pH study and ambulatory pH monitoring can be done at the same time.
An esophageal manometry checks the strength of your esophageal muscles.
This is important because the bottom of the esophagus, called the lower esophageal sphincter (LES), connects to the stomach. If your LES is weak, your stomach contents can move back up into your esophagus and cause acid reflux.
During an esophageal manometry, you sip and swallow water. At the same time, a flexible tube is placed through your nose and into your stomach.
The tube is connected to a computer. When the tube is slowly removed out of your esophagus, the computer measures its muscular contractions.
If the contractions are abnormal, it may indicate GERD.
An esophagram uses X-ray imaging to examine your upper digestive tract.
For this test, you swallow a barium (contrast) solution. This will help your upper digestive tract clearly show up on the X-ray.
The test can help your doctor determine if you have:
When diagnosing GERD, this test can be inaccurate. That’s because you can have a normal esophagram with GERD.
Therefore, it’s not a primary GERD test. Instead, your doctor may use it to monitor your symptoms if you also have swallowing problems.
The most common treatments for GERD include:
If you regularly experience acid reflux, your doctor may recommend a GERD test. This may include an upper GI endoscopy, ambulatory pH monitoring, an esophageal impedance pH study, esophageal manometry, or an esophogram.
The most appropriate test depends on your symptoms and their severity. Talk with your doctor to determine what type of GERD test is best for you.
Last medically reviewed on June 6, 2022