Could You Have GERD? How Doctors Diagnose Gastroesophageal Reflux Disease

Spicy chicken wings. Pizza. Boozin’ until 3 A.M. If you’ve experienced heartburn before, you know that these foods and eating habits are textbook acid reflux triggers.

But what if you begin to experience heartburn regularly, even without alcohol and fried food indulgences?

“If you’re experiencing frequent symptoms, I would say twice a week or more, or you’re requiring frequent over the counter medicine, talk to your doctor about the acid reflux,” says Roshini Raj, MD, a gastroenterologist at NYU Langone Health and co-founder of healthy living brand Tula. 

People who experience heartburn or other acid reflux symptoms at least two to three times a week may have a chronic condition known as gastroesophageal reflux disease, or GERD. If you get acid reflux enough, it can cause bothersome symptoms, injury to the esophagus, or even increase your risk of developing esophageal cancer. 

“You don’t just want to sort of accept this as part of your life,” says Dr. Raj. “You want to make sure that you’re getting the correct diagnosis, evaluation, and the correct treatment.”

How Doctors Diagnose GERD

“In terms of diagnosing GERD, there’s a very typical constellation of symptoms that we ask for and different lifestyle factors,” says Dr. Raj.

Your doctor may ask you:  

• How frequently you experience acid reflux symptoms
• Whether you experience heartburn symptoms at night 
• If you’ve noticed specific food or eating habits that trigger your heartburn symptoms 
• How frequently you eat, the size of your meals, and what you eat
• Your weight and whether it has fluctuated recently
• What medications you may be taking and if you have any other medical conditions

Along with asking you about your symptoms and lifestyle habits, doctors may also perform certain procedures to diagnose GERD, such as:

Endoscopy: An endoscopy is a test where doctors put a scope down a patient’s throat to see if there are signs of acid inflammation in the esophagus. “An endoscopy is a great test because not only does it help assess whether there is acid inflammation in the esophagus, but it’s very helpful to rule out any other causes of these potential symptoms, things like an ulcer or hernia, for example,” says Dr. Raj.

pH monitor: pH monitoring is a 24-hour study of the esophagus. The test involves inserting a thin tube through the nose and into the esophagus for 24 hours. During this time the patient keeps a diary of symptoms. This is usually used to determine the frequency of acid reflux.

UGI series: A UGI series is an X-ray of the upper gastrointestinal tract. The esophagus, stomach, and the first part of the small intestine, are made visible on X-ray film by a liquid. “Sometimes an upper GI series is ordered that looks at the upper GI tract, and it’s also helpful for diagnosing reflux and hernias,” says Dr. Raj.

If you’re diagnosed with GERD, your doctor may suggest certain lifestyle changes, like avoiding certain foods, having smaller, more frequent meals, or losing weight if you need to. 

“I always recommend trying to do the lifestyle and diet changes first, but in many instances it’s not enough, and seeing a doctor and talking about medication options is an important thing to do,” says Dr. Raj.

Here’s how doctors treat GERD and acid reflux with medication.