GERD occurs when stomach acid repeatedly flows back into the esophagus, irritating its lining.
Common symptoms include:
- Heartburn
- Acid regurgitation
- Sour taste in the mouth
- Chest discomfort after meals
- Frequent burping
- Chronic cough
- Hoarseness
- Difficulty swallowing
- Waking up choking at night
👉 New to GERD? Start here:
GERD Explained: Symptoms, Causes, Treatment & When to See a Doctor
Step 1: Your Doctor Will Ask About Your Symptoms
The first and often most important diagnostic tool is:
👉 A detailed medical history.
Your doctor may ask:
- How often do you experience heartburn?
- Does it happen after meals?
- Is it worse when lying down?
- Do symptoms wake you from sleep?
- What foods trigger it?
- Have you tried medications?
- Is there any difficulty swallowing?
If your symptoms are classic for GERD, treatment may sometimes begin without further testing.
⚠️ Red Flag Symptoms That Need Further Investigation
Certain symptoms suggest that more detailed evaluation is necessary.
These include:
- Difficulty swallowing
- Food getting stuck
- Unexplained weight loss
- Vomiting blood
- Black stools
- Anemia
- Persistent vomiting
- Chest pain that isn’t clearly reflux-related
If you have these symptoms, don’t delay seeking medical attention.
🔬 Step 2: Upper GI Endoscopy
One of the most commonly performed investigations is an Upper GI Endoscopy.
This procedure involves passing a thin flexible camera through the mouth to examine:
- The esophagus
- The stomach
- The first part of the small intestine (duodenum)
Endoscopy helps doctors identify:
✔ Esophagitis (inflammation)
✔ Ulcers
✔ Barrett’s esophagus
✔ Hiatal hernias
✔ Narrowing of the esophagus
✔ Signs of cancer
😴 Is Endoscopy Painful?
This is one of the biggest concerns patients have.
The answer?
Most patients tolerate it very well.
Depending on the situation:
- It can be performed with sedation
- The procedure usually takes only 10–20 minutes
- Recovery is typically quick
For many patients, the reassurance gained from knowing exactly what’s happening is worth it.
📈 Step 3: Trial of Medication
Sometimes doctors may diagnose GERD based on how you respond to treatment.
You may be prescribed:
- Proton Pump Inhibitors (PPIs)
- H2 blockers
If symptoms improve significantly, this supports the diagnosis of GERD.
However, medication response alone doesn’t always tell the full story.
📊 Step 4: Ambulatory pH Monitoring
If symptoms persist despite treatment, doctors may recommend 24-hour pH monitoring.
This test measures:
👉 How much acid enters the esophagus over a full day.
It helps answer questions such as:
- Is reflux really occurring?
- How severe is it?
- Are symptoms truly related to acid exposure?
This is especially useful in patients with unclear symptoms.
🥤 Step 5: Esophageal Manometry
Esophageal manometry evaluates how well the muscles of the esophagus work.
Doctors may recommend this test before anti-reflux surgery.
It measures:
- Swallowing coordination
- Esophageal muscle strength
- Function of the lower esophageal sphincter
