Tests and Diagnosis

If you suffer from heartburn or other symptoms of acid reflux on a regular basis or experience severe symptoms, see your healthcare provider for an evaluation. You should see your physician if you're experiencing any of the following:

  • food feels stuck going down and it is hard to swallow
  • your symptoms grow worse
  • you lose weight without trying
  • you have unexplained and ongoing coughing or wheezing

Your baby may have the more persistent form of acid reflux, GERD, if they frequently spit up or vomit (regurgitates) past the age of 18 months. Your baby should be evaluated by a pediatrician. Diagnosing acid reflux is the first step to controlling uncomfortable or severe symptoms and preventing further damage to the esophagus.

To properly diagnose acid reflux, your physician will start with a complete physical exam. Your physician will take several factors, such as whether or not you smoke, into account when making a diagnosis. They'll perform a routine physical exam and ask you questions about your symptoms. Although a completely accurate diagnostic test for GERD doesn't exist, several tests are available to help identify acid reflux.

Barium Swallow Radiograph

A barium swallow radiograph is a noninvasive test that requires drinking a contrast liquid called barium. Barium coats the digestive tract and appears white on radiographs, revealing its shape and condition. Then you will have X-rays taken. X-rays of the upper digestive tract help identify physical abnormalities, such as severe inflammation of the esophagus or a hiatal hernia, which may be responsible for acid reflux and GERD. This test can also show if there is a narrowing of the esophagus (esophageal stricture) or ulcers along the esophagus caused by stomach acids.

Upper Endoscopy

An upper endoscopy is a procedure that uses a lighted, flexible endoscope to see inside the upper gastrointestinal tract. The procedure is performed under light sedation in a doctor's office or hospital. The physician may spray your throat or have you gargle with an anesthetic to numb the area before inserting a thin, flexible, plastic tube with a light and tiny camera on the end (the endoscope) down your throat. This allows the doctor to see the surface of the esophagus and search for abnormalities. The physician can also slide tiny tweezer-like "forceps" through the endoscope, permitting them to take small tissue samples (biopsy). An upper endoscopy is more accurate than a barium swallow radiograph.

Get more information on endoscopy

Ambulatory Acid (pH) Monitoring Examination

In an ambulatory acid (pH) monitoring examination, the physician inserts a tiny, flexible, acid-measuring tube or probe through your nose and into the esophagus above the lower esophageal sphincter muscle. It will remain there for 24 hours. Alternatively, a tiny device can be clipped to the esophagus for 24 to 48 hours.

Your doctor may ask you to record symptoms and meals including when, what, and how much you ate. Over the course of a full day, the ambulatory acid (pH) monitoring probe measures when and how much stomach acid backflows into the esophagus and feeds data into a computer you wear around your waist. The procedure is helpful in diagnosing patients with GERD symptoms but no esophageal damage. The test can also help detect whether or not respiratory symptoms such as wheezing and coughing are brought on by acid reflux.

Learn more about pH monitoring.

Other Tests for Acid Reflux