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Gastro-oesophageal reflux: tests and investigations

Tests that might be used by your doctor to diagnose gastro-oesophageal reflux (sometimes known as GORD) are described below.

Endoscopy

While you are sedated, a small flexible tube with a tiny video camera on the end (called an endoscope) is put down your oesophagus and into the stomach. This allows the doctor to see if there is any inflammation or irritation of the oesophagus as well as being able to rule out the possibility of a stomach ulcer. The doctor may remove a tiny piece of tissue from the lining of the oesophagus during the endoscopy. This sample will be sent for analysis.

Barium meal or swallow

During this test you will drink a thick liquid containing barium, which coats the inside of the oesophagus (gullet) and stomach, making them show up on X-ray. This test is particularly useful for seeing if the gullet has become narrow or ulcerated. The doctor will also be able to see whether the muscles that control swallowing are working.

24 hour acidity or pH monitoring

A fine wire is threaded through your nose down into the oesophagus. This wire is usually left in place for 24 hours while you are at home and a small box, which is usually carried on your belt, makes recordings of the pH or acidity of your oesophagus. This allows the doctor to assess the acidity of your oesophagus during meals and sleep and see whether it is linked to your symptoms. This test is usually undertaken only if there is an uncertainty about a diagnosis, even after an endoscopy.

Oesophageal pressure test or manometry

A thin tube with pressure gauges along its surface is inserted through your nose or mouth and down into the oesophagus. During the test you will swallow small sips of water and the device will measure the pressure in your oesophagus. The device is called a manometer and allows the doctor to determine whether food is passing through the oesophagus normally. This test is very rarely used in the diagnosis of gastro-oesophageal reflux. It is sometimes useful in evaluating difficulty in swallowing where other tests have been normal.


 

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