Diagnosis and Tests for GERD

Many people are diagnosed from their symptoms alone. Tests are used when symptoms are severe, unclear, or come with warning signs.

Clinical diagnosis

Classic heartburn and regurgitation without warning signs often lead to a trial of acid-lowering medicine for a few weeks. If symptoms settle, GERD is likely.

Upper GI endoscopy

A thin camera passes through the mouth to look at the food pipe and stomach. It is advised for:

• Difficulty or pain on swallowing
• Weight loss, vomiting, anaemia or black stools
• Symptoms that continue despite treatment
• Long-standing symptoms or onset after age 50

Small tissue samples (biopsies) may be taken, for example to check for Barrett's oesophagus.

Other tests

• 24-hour pH or impedance monitoring: measures acid and non-acid reflux over a day
• Oesophageal manometry: checks the pressure and movement of the food pipe, mostly before surgery
• Barium swallow: an X-ray that can show hernias or narrowing
• H. pylori test: may be done if ulcer symptoms are suspected

Heart checks

Chest pain should be checked with an ECG and other tests if there is any doubt about the heart.

Key point

Do not stay on acid tablets for months without review. Urgent chest pain with sweating or breathlessness needs 112 or 102.

Before you see a doctor

Bring a list of all your medicines and supplements to the appointment, along with a note of when symptoms occur, what you ate, and whether they wake you at night. This helps your doctor choose the right tests and treatment without delay.