GERD evaluation tests

What Types of Tests Are Needed to Evaluate GERD?

Have you been living with the painful and worrying symptoms of heartburn and acid reflux?

If you’re taking over-the-counter medications like antacids multiple times per week or experiencing frequent discomfort, you might have a more serious condition called GERD. Gastroesophageal reflux disease isn’t just heartburn – it’s a chronic disease caused by constant internal exposure to acid. And, if left unchecked, it can eventually lead to permanent damage.

Worried that your acid reflux might be something more serious?

To find out for sure, you’ll need a few medical exams. Read on for all that you’ll need to know when it comes to diagnostic testing for GERD.

What Is GERD?

Contrary to common belief, GERD is not heartburn. It is a chronic medical disorder caused by acid reflux.

Gastroesophageal reflux disease is defined by frequent bouts of stomach contents and acid backing up into the esophagus, eventually leading to serious internal damage. But, unlike regular heartburn and acid reflux, it might not respond to medication.

Some of the most common GERD symptoms include:

  • chest pain
  • nausea or regurgitation
  • difficult or painful swallowing
  • mouth, throat, or lung problems, like chronic coughing, vocal changes, and asthma

These symptoms may differ from one person to the next, and can be joined by harder to identify issues like tooth degeneration and chronic sore throat. Some patients do not experience any of the common symptoms, including heartburn, regurgitation, or noticeable stomach acid in the throat.

GERD treatment typically includes a combination of lifestyle changes and medication to reduce stomach acid


This test uses X-ray imaging and a barium (contrast) solution to closely examine your upper digestive tract.

While it technically doesn’t test for GERD, an esophogram can help doctors diagnose:

  • severe esophagitis
  • hiatal hernia
  • esophageal stricture (abnormal tightening or narrowing) 

Some patients living with GERD will have a normal esophagram and require additional testing. This type of exam is especially important when symptoms associated with difficult or painful swallowing are present.


Also known as an EGD or upper gastrointestinal (GI) endoscopy, this is the most commonly used test for GERD. 

A small tool known as an endoscope (a camera attached to a flexible tube and light) is inserted into the patient’s mouth and then used to visually inspect the upper digestive tract. This can reveal damage to the esophageal lining caused by GERD, and also allows doctors to view the:

  • esophagus
  • stomach
  • first portion of the small intestine

Because of the slightly invasive nature of this test, IV sedation is required. This means that you will need to arrange transportation to and from your appointment and won’t be able to work or operate heavy machinery afterward.

The EGD takes just 15 to 30 minutes to complete, but you should plan for a full day of recovery. Some patients report mild side effects like gas and bloating, sore throat, and cramping.

An EGD can diagnose far more than just GERD. In fact, it might help doctors better understand a patient’s overall condition, revealing medical issues like ulcers, tumors, inflammation, and varices. It can also help identify disorders like Mallory-Weiss syndrome and Celiac disease.

Esophageal Manometry

Unlike GERD testing that relies on images, esophageal manometry uses computation to check the strength and tone of your lower esophageal muscles, known as the LES or esophageal sphincter.

This band of muscle connects to the stomach, and if it is weakened, stomach contents including acid can move back up into the esophagus. This causes acid reflux, and may eventually lead to GERD.

During the test, patients are asked to sip and swallow water. Meanwhile, a flexible tube is placed through the nose, down the esophagus, and into the stomach. This tube is connected to a computer that measures the strength and frequency of muscular contractions.

If the esophageal muscular contractions appear weak or abnormal, it may indicate GERD.

Ambulatory PH Monitoring

Sometimes, doctors struggle to deliver a solid GERD diagnosis, especially if a patient’s endoscope appears normal.

In these less common cases, doctors rely on ambulatory pH monitoring to detect the presence of stomach acid in the esophagus. This test requires the use of a remote pH-measuring device placed in the esophagus for 24 to 48 hours.

During this time, the frequency, severity, and duration of acid reflux can be accurately monitored.

Ambulatory pH monitoring is the most precise and highly trusted test used to reach a GERD diagnosis. 

Esophageal Impedance PH Study

This test is similar to ambulatory pH monitoring, but uses a different device to monitor the esophagus for stomach acid.

During an esophageal impedance pH study, a flexible tube is inserted through the nose and into the esophagus, where it remains for 24 hours. This tube measures the movement of liquid from the stomach up into the esophagus.

In some cases, this testing is recommended when ambulatory pH monitoring has not delivered an abnormal result, but notable GERD symptoms are present. Doctors may also perform both tests at the same time.

Treat Your GERD Before It Advances

If you suspect that your chronic heartburn or acid reflux might be GERD, it’s time to head to your doctor’s office for testing. 

Don’t wait to take action, as allowing your symptoms to advance can lead to more than discomfort. Eventually, the damage caused by soft tissue exposure to stomach acid will become permanent, requiring a major medical intervention to correct.

Are you seeking a natural alternative to prescription medications like antacids to help relieve the symptoms of GERD? GerdLi offers gerd natural remedies, using the rinds from fruits like oranges, grapefruits, and limes.

Make a one-time purchase to give GerdLi a try, or create a subscription to have your order automatically delivered every month.

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