1. Gastric emptying
Information of stomach emptying can be useful in determining GERD and also in its treatment. In this test, the patient is made to have a meal with a radioactive substance and a sensor is placed over the patient’s stomach to measure how quickly the substance empties. Medications and surgical treatment to cure the symptoms of GERD can be deduced from these studies.
2. Acid perfusion test
After heartburn, chest pain is the second most common symptom of GERD. This diagnostic test is basically performed to determine if the chest pain is associated with acid reflux. A tube is passed through the nose, into the throat and into the middle of the esophagus. Two different dilute solutions, one with acid and the other with normal salt, are perfused alternately through the tube and into the esophagus. If the acid induces the same pain and the salt solution does not trigger any kind of pain, it determines that the acid reflux is responsible for the chest pain experienced by the patient.
3. Esophageal motility testing
Esophageal motility testing is performed to determine the symptoms of GERD which otherwise do not respond to the treatment. This test can evaluate the abnormal working of the esophageal muscle. A tube (catheter) is passed through the nose, into the throat and into the esophagus, with a sensor connected to its tip. The other end of the catheter is connected to a recorder. Pressure is generated in the esophagus and the contraction of the esophageal muscle is detected, and the difference from normal is thus evaluated. Motility testing is also performed before a surgical treatment of GERD to determine if the patient also has a motility disorder of the esophageal muscle.
Esophago-gastro-duodenoscopy, abbreviated as EGD, is a common diagnostic test for GERD. In this procedure, the patient is made to swallow a tube containing an optical system to visually diagnose the esophagus, duodenum and stomach. This type of endoscopy is particularly conducted to determine if the lining of the esophagus is inflamed. It can also determine other aspects of the disease such as ulcers, strictures and Barrett’s esophagus.
Before endoscopy was used as a diagnostic measure, conducting an X-ray was the only method which could determine GERD. To diagnose the disease, the patient is made to swallow barium and an X-ray of the esophagus containing barium is taken. It is effective in cases where the lining of esophagus is damaged, but if the patient has not yet suffered any damage to the esophagus, the test fails to show any other signs of GERD. In today’s practice, X-rays are combined with endoscopy to determine the extent of the damage done by the disease.
6. Characteristic symptoms and response to treatment
This diagnosis is based on the response of the symptom to a particular treatment. Heartburn is a characteristic symptom of GERD. It can be described as a burning sensation under the middle of the chest, and is commonly experienced after meals. It becomes worse with bending or lying down. Frequent episodes of heartburn can be suspected as GERD. To diagnose the disease, doctors often provide medicines to suppress the production of acids in the stomach. If heartburn is then reduced to an extent, it confirms GERD. This is a common diagnostic approach practiced by general physicians which may or may not be followed with other diagnostic tests.
7. Esophageal acid testing
People with GERD suffer from more acid reflux in the esophagus than non-patients. Also, the disease can be determined by the amount of time the esophagus contains acid. This time can be determined with the help of a 24 hour esophageal pH test. In this procedure, a tube (catheter), which has a sensor on its tip that senses acid, is passed through the nose into the esophagus. The catheter placed in the esophagus is connected to a recorder for a 24-hour period in which the acid reflux into the esophagus is monitored. This pH testing method is one of the most accurate methods to determine GERD.