GERD Tests & Diagnosis Methods (Gastroesophageal Reflux Disease)

Generally, a diagnosis of GERD is done symptomatically. However, the following tests are carried out to confirm GERD:

Physical Examination of throat and larynx:
Symptoms of cough, hoarseness or sore throat are observed in patients suffering from GERD. Signs of inflammation of larynx and throat may indicate GERD (2).

X-rays:
This type of diagnostic testing was carried out before the introduction of endoscopy. Permanent pictures (X-ray films) of the esophagus (esophagogram) were taken by advising the patient to swallow barium (contrast material) and the pictures taken with the patient lying in different positions tracing the movement of contrasting material through esophagus. Thus, ulcers and strictures were detected by this method (2).

Endoscopy:
In upper gastrointestinal endoscopy, or Esophago-Gastro-Duodenoscopy (EGD), an optical system for visualization is swallowed and the lining of esophagus, stomach and duodenum examined as it progresses down the gastrointestinal tract (GI tract). Inflamed lining of esophagus (Esophagitis), ulcers, possible cancers, and complications due to GERD such as strictures and Barrett’s esophagus are diagnosed with the help of endoscopy.

Persistent/severe GERD causes changes in cells lining the esophagus turning them initially into precancerous cells and later cancerous, this condition is called Barrett’s esophagus (2).

Esophageal Acid Testing:
This testing is called “gold standard” for diagnosing GERD. The quantity of acid in an individual suffering from GERD is compared to a normal person's level of acid. The Esophagus contains acid most of the time in patients of GERD; this can be determined by a test called the 24-hour esophageal ph test. A small tube called a catheter, with an acid sensor at its tip, is inserted through the nose and positioned in the esophagus. The other end travels down to the waist after exiting from the nose and then attaching to a recorder. The recorder records every reflux episode in the esophagus and a 24 hour frame of data is analyzed.

Another method used for prolonged measurement of 48 hours is with the help of a small, wireless capsule, which is attached to the esophagus just above the Lower Esophageal Sphincter (LES) by passing it through the mouth or nose with the help of a tube. The acid refluxes are measured by the capsule and transmitted to a receiver worn at the waist. The recordings from the receiver are downloaded into a computer and analyzed. The capsule fall of the esophagus after about 3-5 days and passes out through stool, it is not reusable (2).

Esophageal Motility Testing:
Motility testing of the esophagus determines the working of muscles of the esophagus by passing a catheter through a nostril down the throat into the esophagus. The catheter contains a sensor to detect pressure inside the esophagus and the other end is attached to a recorder. The patient is then permitted to swallow sips of water to record and evaluate the esophageal contraction movements. Motility disorders can be rectified sometimes through a surgery (2).

Acid Perfusion Test or Bernstein Test:
This test is used to determine if the chest pain caused is due to acid reflux. A dilute acid solution and a physiologic salt solution are poured into the catheter that is passed through the nostril of the patient into the middle of the esophagus. If the patient experiences pain on pouring the acid solution and if the patient does not experience on perfusion of salt solution, it is implied that the pain is caused due to acid reflux (2).

Conditions & Diseases: Digestive System

GERD (Gastroesophageal Reflux Disease)

Medical Tests & Diagnosis Methods/Tools