Three out of every 10 people experience heartburn on occasion, so it can be somewhat arbitrary to decide when heartburn should be called acid reflux disease.
Also known as gastroesophageal reflux disease (GERD), acid reflux disease is a chronic irritation of the lining of a person's esophagus by stomach acid. Usually, it's just annoying. GERD can, however, have serious consequences, including esophagitis and Barrett's esophagus. Barrett's esophagus is a condition that increases the likelihood of esophageal cancer.
Your description of your symptoms may be all a doctor requires to diagnose heartburn, but sometimes additional testing may be necessary. The esophagus can be viewed through an endoscope, a long, thin, flexible tube inserted through the mouth, or by X-ray.
Sometimes, your doctor may recommend a 24-hour esophageal pH probe study, especially if you have unusual symptoms, such as throat or chest or abdominal pain, coughing, or asthma-like symptoms. In this test, a long, narrow, flexible tube is inserted...
People with acid reflux disease often have some or all of the following symptoms:
Pain when swallowing
Bad breath and/or bad taste in the mouth
How Is Acid Reflux Diagnosed?
If you experience classic symptoms of acid reflux disease -- chronic heartburn and regurgitation -- without any troublesome complications, it may be relatively easy for your doctor to make an acid reflux diagnosis.
A few people have GERD that doesn't respond to treatment. Or they may have other concerning symptoms, such as weight loss, difficulty swallowing, anemia, or black stools. If you're one of them, you may need any of the following tests.
Diagnosing Acid Reflux With a Barium Swallow Radiograph
Your doctor may decide to use a special X-ray procedure -- the barium swallow radiograph -- to rule out any structural problems in your esophagus. In this painless acid reflux test, you will be asked to swallow a solution of barium. The barium enables doctors to take X-rays of your esophagus.
Barium swallow isn't a surefire method of diagnosing GERD. Only one out of every three people with GERD has esophageal changes that are visible on X-rays.
Diagnosing Acid Reflux With Endoscopy or EGD
During an endoscopy, the doctor inserts a small tube with a camera on the end through the mouth into the esophagus. This enables the doctor to see the lining of the esophagus and stomach.
Before inserting the tube, your gastroenterologist may administer a mild sedative to help you relax. The doctor may also spray your throat with an analgesic spray to make the procedure more comfortable for you.
This acid reflux test typically lasts about 20 minutes. It is not painful and will not interfere with your ability to breathe.
While this test may detect some complications of GERD, including Barrett's esophagus, only about half the people with acid reflux disease have visible changes to the lining of their esophagus.
Diagnosing Acid Reflux With a Biopsy
Depending on what the EGD shows, your doctor may decide to perform a biopsy during the procedure. If this is the case, your gastroenterologist will pass a tiny surgical instrument through the scope to remove a small piece of the lining in the esophagus. The tissue sample will then be sent to a pathology lab for analysis. There it will be assessed to see if there is an underlying disease such as esophageal cancer.