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 through the nose down into the esophagus and a probe is left there for 24 hours. This probe detects acid levels to determine if it correlates with your symptoms. A newer technique (called Bravo) measures 24-hour acid; it is done using wireless pH sensors, which eliminates the need for a tube insertion. To detect if your heart is the cause of your symptoms, an electrocardiogram (ECG), a recording of the heart's electrical activity, may be taken.
The hiatus is an opening in the diaphragm (a muscle separating the abdomen and chest) that the esophagus, or swallowing tube, passes through to reach the stomach. If the hiatus weakens and stretches, part of the stomach and/or the esophagus can squeeze into the chest cavity, producing a hiatal hernia.
There are two main types of hiatal hernias: sliding and paraesophageal (next to the esophagus).
In a sliding hiatal hernia, the stomach and the esophagus slide up into the chest through the...
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