Reflux Disease Symptoms and Diagnosis

When acidic stomach contents flow backward (reflux) from the stomach into the esophagus, people experience the symptoms of gastroesophageal reflux disease or GERD.

The most familiar symptom of GERD is heartburn.

Heartburn feels like a burning in the chest below the breastbone, most frequently felt after bending, lying down, or eating. Heartburn is often worse at night and is usually relieved by antacids.

However, not all people suffering from GERD experience heartburn.

Other Symptoms of Acid Reflux

  • Belching
  • Sour taste
  • Coughing
  • Difficulty swallowing
  • Hoarseness, especially in the morning
  • Sore throat or feeling the need to clear the throat
  • Regurgitation of food
  • Gum inflammation
  • Tooth enamel erosion
  • Waterbrash (an excess of saliva)
  • Vomiting blood
  • Nausea and vomiting
  • Wheezing
  • Asthma

Diagnosing Acid Reflux Disease

If you suffer from frequent heartburn or acid reflux, your doctor may order a GERD test to determine if stomach acid has caused any damage to your esophagus. A GERD test may also help your doctor diagnose the underlying cause of your reflux.

Physical examination: A GERD specialist will often examine the throat and larynx of a person who is suspected to suffer from GERD. They will be looking for signs of inflammation or damage and may prescribe acid-suppressing medications if these possible GERD symptoms are discovered.

Upper gastrointestinal endoscopy: This test is commonly used to diagnose GERD. During this procedure, a small tube that contains an optical system is swallowed, allowing it to pass down the esophagus and into the stomach. This GERD test allows your doctor to see any damage or inflammation to the esophagus as well as ulcers, inflammation or cancers of the stomach or duodenum.

Biopsies: In some cases, a biopsy may be performed during an upper gastrointestinal endoscopy. By removing sample tissues, your doctor may be able to detect Barrett’s esophagus or certain types of cancer.

X-ray: Once the only means of detecting GERD, an x-ray of the esophagus, or esophagram, requires the patient to swallow barium before the procedure. Pictures taken can then show damage to the esophagus caused by acid reflux, including ulcers and strictures.

Acid Perfusion Test: Also known as the Bernstein test, an acid perfusion test helps verify that chest pain is caused by acid reflux. During these GERD diagnostic tests, a thin tube is inserted into the nose and down the back of the throat to the esophagus. Two solutions are then inserted into the esophagus through the tube: a dilute, acid solution and a physiologic, salt solution. If the chest pain can be recreated with the acid solution and the salt solution causes no pain, it is likely that acid reflux is the cause of chest pain.

Gastric Emptying Study: It’s estimated that 20% of GERD cases are related to slow emptying of the stomach. Gastric emptying studies help determine how long it takes for food to be emptied from the stomach. During these tests, the patient consumes food that contains a radioactive substance. A sensor that can track the radioactive substance is then placed over the stomach in order to monitor how long it takes the food to be emptied. This GERD diagnostic test is useful if medications that target acid production are not controlling symptoms.

Esophageal Motility Testing: Other GERD diagnostic tests known as esophageal motility testing are designed to examine the effectiveness of the muscles in the esophagus. Some recent studies have suggested that weak muscle tone in the esophagus can cause GERD. Like acid profusion tests, motility testing also requires a tube to be inserted into the esophagus through a nostril. However, the tube used during a motility test is equipped with pressure sensors. These sensors measure the pressure in the esophagus while the patient swallows sips of water. These GERD diagnostic tests are very useful for uncovering other underlying health problems that may be causing symptoms that mirror GERD.

Esophageal Acid Testing: While there are many possible GERD diagnostic tests that your doctor could recommend, one of the most commonly used and reliable is esophageal acid testing. Using a 24-hour esophageal pH test, doctors can determine how often there is acid in the esophagus. People who suffer from GERD will have acid in their esophagus more often than people who do not have GERD.