Gastroesophageal Reflux Disease (GERD)

Diagnosis

Highly trained gastrointestinal specialists work with thousands of patients each year to diagnose mild to severe cases of GERD. A doctor should be consulted about any of the following symptoms of GERD:

• Frequent heartburn, or a burning pain behind the breastbone, often accompanied by a sour taste and the sensation of food coming back into the mouth. It often gets worse when a person eats, bends over or lies down.
• Chest or upper abdomen pain, especially pain that disrupts sleep
• Regurgitation (backflow of stomach fluids into the mouth)
• Difficulty swallowing
• Belching, especially belching that is acidic or sour-tasting
• Chronic sour or bitter taste in the mouth
• Hoarseness, especially in the morning
• Sore throat
• Coughing, wheezing or repeated need to clear the throat

Testing

If more serious symptoms (such as severe heartburn, difficulty swallowing or weight loss) are present or if heartburn is not relieved by medications, then further testing is required. The following tests may be performed:

• Esophagoscopy
  Using an instrument called an endoscope, doctors can inspect the esophagus and take a small sample of tissue that appears abnormal.
• Barium swallow
  An X-ray test that outlines the esophagus.
• Cardiac evaluation
  Patients whose GERD symptoms include chest pain may also need an electrocardiogram (called ECG or EKG) and an exercise stress test to rule out heart disease.
• Esophageal manometry or motility studies
  These studies measure how tightly the LES shuts, and determines abnormalities in esophageal pressure and movement.
• Esophageal pH monitoring
  One test uses electrodes to measure the pH (acid level) in the esophagus. A catheter is placed through the nose and into the esophagus for 24 hours. In another test (the Bravo system), a miniature capsule is attached to the esophagus for 48 hours and information is transmitted to a small receiver worn on the belt.