Heartburn (cont.)

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Medical Author:

Yesha R Patel, MD

Coauthor:

David Jerrard, MD

Coauthor:

Vincent W Yang, MD, PhD

Medical Editor:

Simmy Bank, MD, MB, ChB

Medical Editor:

Francisco Talavera, PharmD, PhD

Medical Editor:

BS Anand, MD

Exams and Tests

Heartburn may be obvious from your symptoms, so your health care provider may not need to perform any tests or do an extensive exam. You may be advised about lifestyle modifications, diet, or medications to begin immediately.

Your provider may order certain procedures if the diagnosis is unclear or if prescribed medications are not relieving your heartburn.

The most common procedure is called an upper GI (gastrointestinal) endoscopy, also called esophagogastroduodenoscopy or EGD. You are lightly sedated. A special camera is placed through your mouth and into the esophagus and stomach. The doctor can then see how much damage has been done to the esophagus from stomach acid. The doctor will also be able to determine and possibly treat the complications of heartburn, such as problems swallowing or bleeding. In addition, an upper endoscopy will let your doctor see if there are other explanations for the pain, such as an infection.
You may undergo an upper GI series. In this test, you drink a liquid that coats your esophagus and stomach and shows up on x-rays that are taken.
If an upper endoscopy shows that everything is normal but you continue to have pain, the doctor may do further testing to clarify the diagnosis. This includes procedures to measure the weakness of the LES muscle. This procedure is called an esophageal manometry.
Another procedure is the 24-hour pH monitoring to measure the strength of your stomach acid. A very thin tube is passed through your nose into your esophagus. For the next 24 hours, the test measures the amount of acid reflux that occurs while you go about your regular activities, including eating. A new test uses a tiny capsule to measure acid reflux levels. The doctor uses an endoscope to attach the bean-sized capsule to your esophagus. It 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 through your digestive system and is not recovered.
If your health care provider feels you are at risk for heart problems, additional tests may be performed to make sure your heart is healthy.