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.
You thought you have a simple case of heartburn, but lately, after adding a few inches to your waistline, it's more than that: a frequent feeling of pain under your breastbone; the faint taste of acid on the back of your tongue; trouble sleeping a few times a week; and problems swallowing.
It happens when you eat too much, when you doze on the couch after dinner, and when you have too many drinks during cocktail hour. Chowing down a few slices of pepperoni pizza doesn't seem to be a problem, but...
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Jennifer Robinson, MD on August 26, 2014