How is GERD diagnosed?

Diagnosing GERD is fairly straightforward when classic symptoms such as heartburn and acid indigestion are present. Your doctor will suggest lifestyle changes and medications to treat heartburn. If you respond to the treatment, then your diagnosis of GERD is confirmed.

In addition, your doctor may order diagnostic tests to confirm a diagnosis of GERD. These tests attempt to visualize the lining of the esophagus to determine if it has been damaged. There are several procedures commonly used to diagnose GERD:


Barium swallow radiograph. After drinking a barium solution, X-rays are taken to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus.

Upper endoscopy. This is performed in a hospital or doctor's office. The doctor will spray your throat with a numbing solution. Then, she will slide a thin, flexible plastic tube called an endoscope down your throat. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. Usually, the esophagus of most patients with symptoms of reflux appears normal; therefore, endoscopy generally does not aid in the diagnosis of GERD. However, endoscopy does help detect esophagitis (inflamed esophagus) and breaks or ulcers in the esophageal lining, so following these findings a diagnosis of GERD can be made. Endoscopy will also identify some of the complications of GERD, e.g., ulcers, strictures and Barrett's esophagus

Biopsies. A biopsy of the esophagus obtained through the endoscope can reveal damage caused by acid reflux and rule out other problems if no infection or abnormal growths are found. The doctor will use small tweezers to retrieve tissue to examine.

Esophageal acid testing. A tiny tube is inserted into your esophagus. This tube stays in place for 24 hours. During that time you go about your normal activities, and the device measures when and how much acid comes up into your esophagus.