Although gastroesophageal reflux disease (GERD) is a common digestive condition, its proper diagnosis is critical to fully understand your condition, determine its severity, develop an appropriate treatment plan, and take steps to prevent GERD from worsening over time. Because some other conditions and diseases have symptoms that are similar to GERD, it is important to confirm that your symptoms are from GERD and not another, potentially more serious, condition.
Whether you have a mild or a more complicated form of GERD, you can trust the expertise of the specialists at Cooper to fully evaluate your symptoms, diagnose your condition and provide the most advanced GERD treatment options available.
The Physical Examination
As the first stage of your GERD diagnosis, one of Cooper’s experts will review your symptoms to determine what kind of GERD you may have. In addition, you and your physician will discuss your medical and family history of GERD and other conditions like Barrett’s esophagus, and any previous tests and procedures you may have had.
Based on this information, your doctor will work with you develop an appropriate treatment plan and schedule times for any tests you may need. The tests and procedures your Cooper specialist may recommend will depend on your specific symptoms, their severity, your medical and family history and how you have previously responded to other treatments. These diagnostic tests may include an esophagogastroduodenoscopy (EGD), esophageal manometry, pH testing and imaging studies, among others. You will then have a follow-up appointment with your GERD specialist in two to three months.
GERD Diagnostic Methods
Cooper’s specialists are highly skilled in conducting the latest and most advanced diagnostic tests for GERD. The tests your doctor may recommended will depend on your initial consultation and information from your primary care physician.
Although an upper endoscopy is the most common diagnostic test for GERD, other diagnostic tests may be appropriate based on your unique circumstances, including:
- Barium esophagram (also called a barium swallow)
- Upper GI series
- High-resolution esophageal manometry
- pH-Impedance testing
- Bravo wireless pH testing
- Transnasal esophagoscopy
Blood tests are not an appropriate diagnostic test because GERD is not caused by a virus or bacteria. The following diagnostic tests allow your physician to view the gastrointestinal tract and are the most effective in obtaining a proper GERD:
Upper endoscopy is the primary test used to diagnose GERD and requires sedation. During the procedure a doctor inserts a thin and flexible tube, or endoscope, down the throat to view areas of the gastrointestinal tract, including the esophagus, the stomach and part of the small intestine. Other diagnostic tests for GERD may be used only for unique circumstances.
A barium esophagram – often referred to as a barium swallow – is an imaging test that uses X-rays to look at the upper GI tract (the back of your mouth, throat, and part of the esophagus). The barium is mixed into a drink before the procedure and makes parts of the upper GI tract more visible on the X-ray or on fluoroscopy, which uses real-time video. A barium swallow may be used alone or as part of an upper GI series.
Upper GI Series
An upper gastrointestinal (GI) series involves X-rays imaging of the esophagus, stomach and part of the small intestine. Before the procedure patients drink a mixture that includes a barium contrast that coats the walls of the organs in the upper GI tract, allowing physicians to observe how a patient swallows and how well the organs are working.
High-Resolution Esophageal Manometry
High-resolution esophageal manometry is used to detect motility disorders of the esophagus and is often used to determine if there are problems with the way food moves from the esophagus to the stomach. The procedure involves passing a thin, flexible tube with pressure sensors through the nose, down the esophagus and into the stomach while measuring the pressure, patterns and the activity of sphincter muscles in the esophagus.
In general, pH testing assesses the level of acid and non-acid reflux in the esophagus. One form of pH testing – called a 24-hour pH-impedance test – involves inserting a thin catheter into the nose, down through the esophagus, and into the stomach to monitor acidity changes through the course of a day.
Bravo Wireless pH Testing
A wireless esophageal pH test – also called a Bravo test – is a minimally invasive procedure that measures the level of acidity (pH level) in the esophagus. Often used if GERD symptoms are not responding to medication, the diagnostic test involves inserting an endoscope down the throat and into the esophagus to place a probe that records the pH over time. The probe transmits the information to a transmitter worn on the patient’s belt and the physician will use that information to evaluate the severity of a patient’s GERD.
During a transnasal esophagoscopy (TNE), a thin, flexible tube is inserted into the nose, down through the esophagus and into the stomach. A small light and camera on the tube allows the doctor diagnose problems with the esophagus and stomach. TNE is a quick procedure that can be done in the doctor’s office and may be used as an alternative to upper endoscopy, which requires sedation.
Make an Appointment With a GERD Expert
Make an appointment with a Cooper specialist if you have GERD and are still experiencing acid reflux more than twice a week after making dietary changes.