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Diagnosis of Gastro-Oesophageal Reflux Disease

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Those patients with symptoms that arrive without warning, and are compatible with the disease, can receive treatment with proton pump inhibitor (PPI) drugs for at least two weeks, without needing additional tests. Warning signs are: anaemia due to iron deficiency, unjustified weight loss, dysphagia, persistent vomiting or digestive bleeding.

Additional tests

Endoscopy. This is done if a patient has: GORD symptoms that do not respond to treatment; atypical symptoms; warning signs; or chronic GORD with risk factors for a condition called Barrett's oesophagus.

Barrett's oesophagus

Barrett's oesophagus is a disorder in which the mucosa of the oesophagus is replaced by stomach mucosa, precisely to better adapt to reflux, which is why the symptoms of GORD are usually less.

Endoscopy helps in checking mucosal injury caused by acid (known as oesophagitis) and its extent; Barrett's oesophagus; and to exclude other diseases that may explain the patient’s symptoms.

Functional tests, such as pH or pH-impedance testing to detect acidity levels in the oesophagus. They are performed on patients who do not respond to treatment; when the presence of reflux has to be confirmed in symptomatic patients with normal endoscopy; and as a study before anti-reflux surgery. In these tests, reflux from the gastric cavity to the oesophagus is monitored for 24 hours, while the patient leads a normal life and eats food that can cause reflux. For this reason, this test is not done with sedation. It also detects cases where there is no excessive gastro-oesophageal reflux, but the patient perceives it as such.

High resolution oesophageal manometry. This helps in studying the movement of the oesophagus and the relaxation of the lower oesophageal sphincter. A probe with pressure sensors is inserted through the patient's nose and the movement of the oesophagus is observed while liquids are administered through the mouth.

Substantiated information by:

Helena Hernàndez Èvole Gastroenterologist Gastroenterology Service

Published: 29 November 2023
Updated: 29 November 2023

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