How is GERD diagnosed or evaluated?

A well-taken patient history is the first step to establishing a diagnosis of GERD. If the patient has the classic heartburn and regurgitation symptoms then a diagnosis of GERD can be made with a good deal of accuracy. However, patients who may not have typical symptoms may be misdiagnosed. Also, symptoms similar to GERD symptoms may actually be symptoms of another, potentially life-threatening disease, such as coronary artery disease.

There is no gold standard or definitive test that exists for a doctor to use to accurately diagnose GERD. A test called a pH probe is accepted as the standard for establishing or excluding the presence of GERD, but the test is not highly accurate. Radiographic studies, including double-contrast barium radiography, have limited usefulness in diagnosing GERD. Reflux and regurgitation are not readily visible during endoscopic screening, but complications and damage to the esophagus from GERD are. Therefore, the role of endoscopy in the average patient has shifted from making a diagnosis of GERD to helping to determine the long-term risk of complications.

GERD is most often diagnosed after the physician suspects GERD during a history and physical exam and gives the patient a successful 4-8 week trial course of acid reflux medications.