Heartburn alone is a relatively benign symptom, and is very common, with three in 10 people experiencing heartburn at least once a month. Chronic irritation of the esophagus caused by acid reflux or GERD can lead to more serious complications if not diagnosed and treated effectively. If your acid reflux is left untreated, it could cause tooth decay, damage your esophagus, and eventually lead to esophageal cancer.
Acid reflux disease may be diagnosed using any one or a combination of the following tests:
- Barium Swallow Radiograph, or upper GI. A type of x-ray procedure in which the patient will drink a barium solution—a white, chalky substance referred to as a barium shake— enabling doctors to easily see the organs on the x-ray as the barium moves through the intestinal tract. An upper GI is used to rule out any structural problems in the esophagus. This test requires fasting eight hours prior to the test to ensure the upper portion of your gastrointestinal tract is clearly visible on the x-ray. Only one in three people with GERD will have noticeable esophageal changes visible on x-rays, so this test isn’t always conclusive. A hiatal hernia may also be readily apparent on this examination.
- Endoscopy, or EGD. During this procedure, a small tube with a camera is inserted through the mouth into the esophagus while the patient is under sedation, allowing the doctor to see the lining of the esophagus and stomach. The doctor will be able to see any signs of inflammation, hernias, or ulcers, which may be causing your symptoms. This test may detect complications of GERD, such as esophagitis and Barrett’s esophagus. The EGD procedure should last about 20 minutes and is not painful.
- Biopsy. A biopsy may be performed during an EGD, depending on what is discovered during the EGD procedure. In a biopsy, a small piece of the lining of the esophagus is removed and sent to pathology lab for analysis to determine if there is any underlying disease, such as cancer, ulcers, or infection.
- Esophageal Manometry. This test assesses esophageal function and checks to be sure the esophageal sphincter—a small valve between the stomach and esophagus—is working properly. In this procedure, a narrow, flexible tube is passed through the nose through the esophagus and into the stomach. Sensors on the tube measure pressure exerted at various locations within the esophagus and stomach.
- pH Monitoring. A pH test records the acidity in the esophagus over a 24- to 48-hour period. During this test a pH sensor is placed in the esophagus, either at the end of a small tube, or by suction. The patient carries a recording device to track any symptoms of acid reflux and will keep a diary of foods and drinks consumed during the test period allowing the physician to determine the frequency and severity of the patient’s reflux.