Diagnosis and tests for reflux disease

Most people with typical heartburn are diagnosed from their symptoms and a clinical history. Tests are used when symptoms are severe, do not respond to treatment or come with warning signs.

Clinical assessment A doctor asks about the pattern of symptoms, triggers, medicines, weight change and swallowing. A trial of acid-reducing medicine for a few weeks is often used, and a good response supports the diagnosis.

Upper gastrointestinal endoscopy A thin camera is passed through the mouth to look at the oesophagus and stomach. It shows inflammation, ulcers, hiatus hernia and Barrett's oesophagus, and allows a small tissue sample (biopsy) if needed. It is usually done with sedation or throat numbing.

Ambulatory pH monitoring A thin tube or small capsule measures how often acid enters the oesophagus over 24 to 48 hours. It helps when the diagnosis is uncertain.

Oesophageal manometry This measures the strength and coordination of the food pipe muscles, and is usually done before anti-reflux surgery.

Barium swallow An X-ray test after drinking a contrast liquid that can show narrowing or a large hiatus hernia.

Other tests Blood tests for anaemia, and testing for H. pylori infection when relevant. An ECG may be done to rule out heart causes of chest pain.

Ayurvedic view (interpretive) Traditional assessment looks at digestion, appetite, taste and stool patterns. These observations may add context but cannot confirm reflux disease or its complications.

Remember See a doctor first if you have chest pain, swallowing trouble, vomiting blood or weight loss before trying home measures.