Your doctor may be able to diagnose gastroesophageal reflux disease, or GERD, from your description of symptoms. The doctor may also suggest tests to rule out other possible causes of your symptoms, to monitor the degree of damage, or to determine the best treatment for you.
The three main tests used when GERD is suspected or known are esophageal pH monitoring, endoscopy, and manometry. With pH monitoring, the doctor measures the amount of acid in the esophagus over a 24-48 hour period. This test is used mainly to rule out GERD if symptoms are not typical for acid reflux. It is also very helpful in identifying patients who may need surgery as a treatment for GERD.
Endoscopy uses a flexible tube with a light and video camera on the end. The tube is passed through the throat into the esophagus so the doctor can examine the esophagus for esophagitis (inflammation of the esophagus), strictures (narrowing of the esophagus, and for Barrett's esophagus (a specific, abnormal change in the lining of the esophagus). This is important to recognize because -- rarely -- Barrett's can lead to cancer of the esophagus. Endoscopy usually is not done if symptoms are mild. If they are more severe, prolonged, or do not respond to treatments, including lifestyle changes and medications, your doctor may want an endoscopy. If you have Barrett's esophagus or severe esophagitis, your doctor may suggest regular endoscopy monitoring to screen for cancer.
Manometry identifies problems with motility and valve pressure in the esophagus. This study allows doctors to measure function of the lower esophageal valve (LES). Manometry can also be helpful in evaluating GERD patients for surgery.
What Are the Treatments for GERD?
GERD is a chronic disease, and the goal of treatment is to manage it; that means reducing the amount of acid in the stomach and the amount of reflux that occurs. For mild GERD, this can sometimes be accomplished by using over-the-counter antacids and making certain lifestyle changes. If more treatment is needed, other types of drugs, either over-the-counter or prescription, are available. Treatments are also available that can be done using the endoscope. Very rarely, surgery will be needed.