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Tests and diagnosis

By Mayo Clinic staff

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Illustration showing endoscopy 
Endoscopy

To determine if your heartburn is a symptom of GERD, your doctor may suggest one or more tests and procedures, including:

  • An X-ray of your upper digestive system. Sometimes called a barium swallow or upper GI series, this procedure involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract. Then X-rays are taken of your upper digestive tract. The coating allows your doctor to see a silhouette of the shape and condition of your esophagus, stomach and upper intestine (duodenum).
  • Passing a flexible tube down your throat. Endoscopy is a way to examine the inside of your esophagus. During endoscopy, your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat. The endoscope allows your doctor to examine your esophagus and stomach. Your doctor may also use endoscopy to collect a sample of tissue (biopsy) for further testing. Endoscopy is useful in looking for complications of reflux, such as Barrett's esophagus.
  • A test to monitor the amount of acid in your esophagus. Ambulatory acid (pH) probe tests use an acid-measuring device to identify when, and for how long, stomach acid regurgitates into your esophagus. The acid monitor can be a thin, flexible tube (catheter) that's threaded through your nose into your esophagus. During the test, the tube stays in place and connects to a small computer that you wear around your waist or with a strap over your shoulder. Or the acid monitor can be a clip that's placed in your esophagus during endoscopy. The probe transmits a signal to a small computer that you wear around your waist for about two days, and then the probe falls off to be passed in your stool. Your doctor may ask that you stop taking GERD medications to prepare for this test.
  • A test to measure the movement of the esophagus. Esophageal motility testing measures movement and pressure in the esophagus. The test involves placing a catheter through your nose and into your esophagus.
Your doctor also may order additional tests to rule out other conditions, such as heart disease.
References
  1. Ferri FF. Gastroesophageal reflux disease. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00016-0--sc0030&isbn=978-0-323-05610-6&type=bookPage&sectionEid=4-u1.0-B978-0-323-05610-6..00016-0--sc0030&uniqId=239147718-3. Accessed April 13, 2011.
  2. Kahrilas PJ. Clinical manifestations and diagnosis of gastroesophageal reflux in adults. http://www.uptodate.com/home/index.html. Accessed April 13, 2011.
  3. Kahrilas PJ. Medical management of gastroesophageal reflux disease in adults. http://www.uptodate.com/home/index.html. Accessed April 13, 2011.
  4. Michelfelder AJ, et al. Integrative medicine and gastrointestinal disease. Primary Care: Clinics in Office Practice. 2010;37:255.
  5. Kiefer D. Gastroesophageal reflux disease. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-2954-0..50046-6&isbn=978-1-4160-2954-0&type=bookPage&sectionEid=4-u1.0-B978-1-4160-2954-0..50046-6&uniqId=239147718-7. Accessed April 13, 2011.
  6. Achem SR. Noncardiac chest pain - Treatment approaches. Gastroenterology Clinics of North America. 2008;37:859.
  7. Understanding heartburn and reflux disease. American Gastroenterological Association. http://www.gastro.org/patient-center/digestive-conditions/heartburn-gerd. Accessed April 13, 2011.
  8. Kahrilas PJ, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135:1383.
  9. Fennerty MB, et al. Short- and long-term management of heartburn and other acid-related disorders: Development of an algorithm for primary care providers. The Journal of Family Practice. 2009;58:S1.
  10. Weight management. U. S. Department of Agriculture. http://www.nutrition.gov/nal_display/index.php?info_center=11&tax_level=3&tax_subject=390&topic_id=1741&level3_id=6295&level4_id=0&level5_id=0&placement_default=0. Accessed April 13, 2011.
  11. Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2011.
DS00095 May 21, 2011

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