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Your health care provider may be able to diagnose gastroesophageal reflux disease just by the symptoms you report. If symptoms continue for more than 4 weeks despite this therapy, you may be referred to a gastroenterologist. If your symptoms are severe, you may have to undergo some tests.

There is no simple blood test for GERD. The tests used to diagnose GERD include the following:

• Upper GI (gastrointestinal) endoscopy: While you are lightly sedated, a thin tube is passed down your esophagus. The tube has a light and a tiny camera on the end. The camera sends pictures of your esophagus to a video monitor. The doctor can then see how much damage has been done to the esophagus from stomach acid. The endoscopy also shows other causes of similar symptoms, such as ulcers or infections, and whether you have any complications, such as bleeding. Some problems can actually be treated with the endoscope.



• Upper GI series (barium swallow): This is a series of x-rays of your chest and abdomen taken after you swallow a liquid that coats the inside of your esophagus and stomach. This liquid provides contrast so that any problems are easier to see. This test gives less information than endoscopy but is sometimes ordered to rule out other conditions such as ulcers, hiatal hernia, or motility disorders. Sometimes the upper GI series is skipped altogether.



• Esophageal manometry: This test measures the strength of the lower esophageal sphincter and the contraction movement of the esophagus after a swallow. This test is usually performed if an upper GI endoscopy shows nothing abnormal but you continue to have pain, which is often due to spasm (contraction of the esophagus).



• 24-hour pH monitoring: This test measures the strength of your stomach acid. A very thin tube is passed through your nose into your esophagus and kept in place for the next 24 hours. During this period, the test measures the amount of acid back-up that occurs while you go about your regular activities, including eating and sleeping. The newest version of this test uses a tiny capsule to measure acid back-up. The doctor uses an endoscope to attach the bean-sized capsule to your esophagus. The capsule measures pH levels and delivers readings by radio wave to a receiver you wear on your belt. After about 48 hours, the capsule detaches and passes harmlessly through your digestive system.

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