Acid reflux - Diagnosing GORD

Your GP will often be able to diagnose gastro-oesophageal reflux disease (GORD) based on your symptoms.

They may prescribe medication to treat it without needing to carry out any tests. Read more about treating GORD.

When tests may be needed

You'll usually only need to be referred for tests in hospital if:

your GP is unsure whether you have GORD
your symptoms are persistent, severe or unusual
prescription medications aren't controlling your symptoms
your GP thinks you might benefit from surgery
you have signs of a potentially more severe condition, such as difficulty swallowing or unexplained weight loss

Tests can help to confirm the diagnosis of GORD, check for other possible causes of your symptoms and determine whether you may be suitable for surgery.

Tests for GORD

Tests you may have include:

an endoscopy
a barium swallow or barium meal test
manometry
24-hour pH monitoring
blood tests

Endoscopy

An endoscopy is a procedure where the inside of your body is examined using an endoscope, which is a long, thin, flexible tube with a light and camera at one end.

The endoscope will be gently inserted into your mouth and down your throat. The procedure is usually carried out while you're awake, but you may be given a sedative to help you relax.

The camera can show if the surface of your oesophagus (gullet) has been damaged by stomach acid, although this doesn't happen to everyone with GORD.

Barium swallow or barium meal

A barium swallow, or barium meal, is a test to assess your swallowing ability and look for any blockages or abnormalities in your oesophagus.

You are first given some barium solution, then some X-rays are taken. Barium is a harmless substance that shows up clearly on X-rays as it passes through your digestive system.

You'll be asked not to eat anything for a few hours before the procedure. Afterwards, you'll be able to eat and drink normally, although you may need to drink more water to help flush the barium out of your body.

Manometry

Manometry is used to assess how well the ring of muscle at the end of your oesophagus is working, by measuring the pressure in your oesophagus.

This can rule out other possible causes of your symptoms and can help determine whether surgery would be suitable.

During the procedure, a small tube will be passed up your nose and then down into your oesophagus. The tube contains pressure sensors that can detect the pressure in the oesophagus.

24-hour pH monitoring

It may be necessary to measure the acidity level (pH) in your oesophagus to confirm a diagnosis of GORD if nothing is found during an endoscopy.

The acidity level is measured over 24 hours, using a thin tube containing a sensor that's passed up your nose and down your oesophagus. This is usually connected to a recording device worn on your waist.

You'll be asked to press a button on the recorder every time you become aware of your symptoms and to record your symptoms in a diary. You should eat as you normally would during the test to ensure an accurate result.