Your doctor or gastroenterologist may wish to evaluate your symptoms with additional tests when it is unclear whether your symptoms are caused by acid reflux, or if you suffer from complications of GERD such as dysphagia (difficulty in swallowing), bleeding, choking, or if your symptoms fail to improve with prescription medications. Your doctor may decide to conduct one or more of the following tests.
Upper GI Series
For the upper GI series, you will be asked to swallow a liquid barium mixture. The radiologist then takes a series of pictures and videos to watch the barium as it travels down your esophagus and into the stomach.
You will be asked to move into various positions on the X-ray table while the radiologist watches the GI tract. Permanent pictures (X-ray films) will be made as needed.
This test involves passing a small lighted flexible tube through the mouth into the esophagus and stomach to examine for abnormalities. The test is usually performed with the aid of sedatives. It is the best test to identify inflammation of the esophagus and pre-cancerous conditions of esophagus (Barrett's esophagus), or other complications of the esophagus.
Acid (pH) Testing
The diagnosis of GERD is often made based on physical and history alone. However occasionally direct measurement of the amount of acid/fluid refluxed into the esophagus is necessary to help diagnose and treat GERD. A pH test involves either placement of a small catheter through the nose into the esophagus or a small chip directly attached to the esophagus during endoscopy which can provide objective data about the the degree of acid reflux.
Besides heartburn and regurgitation, GERD can result in a number of other symptoms outside of the esophagus.
Chest Pain: Patients with GERD may have chest pain similar to angina or heart pain. Usually, they also have other symptoms like heartburn and acid regurgitation. If your doctor says your chest pain is not coming from the heart, do not forget about the esophagus. On the other hand, if you have chest pain, you should not assume it is your esophagus until you have been evaluated for a potential heart cause by your physician.
Asthma: Acid reflux may aggravate asthma. Recent studies suggest that the majority of asthmatics have acid reflux. Clues that GERD may be worsening your asthma include: 1) asthma that appears for the first time during adulthood; 2) asthma that gets worse after meals, lying down or exercise; and 3) asthma that is mainly at night. Treatment of acid reflux may cure asthma in some patients and decrease the need for asthmatic medications in others.
Ear, Nose, and Throat Problems: Acid reflux may be a cause of chronic cough, sore throat, laryngitis with hoarseness, frequent throat clearing, or growths on the vocal cords. If these problems do not get better with standard treatments, think about GERD.