Recently I looked at my personal health file and saw that I was diagnosed with GERD some 6 years ago. This seemed strange to me since I did not remember any occasion in which I was positively diagnosed with this disease (I did not even know what it is until I looked at Google). I asked my personal doctor (who is new) and he also did not know. This might be a mistake in the computer files. So my question is: what physical examination can be used to decide whether a patient has GERD or not?
GERD is usually diagnosed based on history and signs and symptoms. If you complained of frequent heartburn or told your doctor you often take antacids, it's possible he based it on that. Confirming GERD can involve the following tests:
- Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Test results can often be normal when reflux is present, but an endoscopy may detect inflammation of the esophagus (esophagitis) or other complications. An endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications such as Barrett's esophagus.
- Ambulatory acid (pH) probe test. A monitor is placed in your esophagus to identify when, and for how long, stomach acid regurgitates there. The monitor connects to a small computer that you wear around your waist or with a strap over your shoulder. The monitor might be a thin, flexible tube (catheter) that's threaded through your nose into your esophagus, or a clip that's placed in your esophagus during an endoscopy and that gets passed into your stool after about two days.
- Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.
- X-ray of your upper digestive system. X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help diagnose a narrowing of the esophagus that may interfere with swallowing.