At least 20% of adults have gastroesophageal reflux disease (GERD). In this blog, we explain why diagnosing GERD is important and how it determines better treatment.

People understand that what they eat and drink can trigger heartburn or acid reflux flare-ups and discomfort. What some of these same people might not know is that medication-based treatments won’t stop their acid reflux. This is why diagnosing gastroesophageal reflux disease (GERD) and its cause is so important.

For example, of the nearly two in 10 adults in the U.S. believed to have GERD, an estimated 30% do not respond to medications designed to reduce the acids in their stomachs (proton-pump inhibitors).

Meet our GERD specialists here.

Furthermore, while antacids and other medications may reduce symptoms, they do not prevent GERD from recurring because they do not address the underlying cause. Diagnosing GERD can point to the correct treatment.

Untreated, the stomach acids and enzymes forced up can inflame the tube that carries your food and drink (esophagus) and lead to complications. These include a narrowing of the food pipe (esophageal stricture); swallowing disorders (dysphagia); and Barrett’s esophagus, a cell-mutating complication of GERD that can, in rare cases, develop into esophageal cancer.

Fortunately, you have the option to select a GERD diagnosis that will inform the best treatments, including medications.

Reflux Explained and Why to Consider Diagnosing GERD

This is an opportune time to learn more about GERD diagnoses. GERD Awareness Week is Nov. 23 to 29, and the whole month of November is Stomach Cancer Awareness Month. Both events support education for patients with gastrointestinal issues, including GERD.

Awareness is essential because GERD is often misunderstood and confused with simple heartburn or acid reflux, when the contents of your stomach push back up into the esophagus. You shouldn’t just assume you have acid reflux.

Here is the difference:

Acid reflux is occasional and very common. There’s a good chance you have experienced it at some time in your life, perhaps after an unusually large meal or lying down right after eating. The telltale signs include burning in your chest and a sour backwash from the acid rising into your esophagus.

GERD differs from acid reflux in that it is chronic, occurring at least twice a week for several weeks. The condition is caused by a weakened muscle at the base of the esophagus, known as the lower esophageal sphincter, which should open only to allow food into the stomach and then close tightly.

Symptoms that Suggest Seeing Your Doctor to Diagnose GERD

Risk factors of GERD include obesity, pregnancy, exposure to tobacco smoke, and taking certain medications. You know you have GERD, not merely heartburn or acid reflux, when you feel the following symptoms:

• A sore throat and/or cough that is chronic.
• Persistent burping and bad breath.
• Pain when swallowing, as well as chest pain.
• Feeling like food sticks in your throat.
• Nausea and/or vomiting.
• Inflamed gums and eroding tooth enamel.

If you have been experiencing these symptoms for several weeks or more, it may be time to consult a gastroenterologist to diagnose GERD. Untreated, the continuous backflow of your stomach’s contents can mutate the cells in your esophagus, making them resemble your stomach’s lining. This is Barrett’s esophagus, and it can contribute to esophageal cancer due to the abnormal cell activity.

Be aware that the symptoms of GERD and Barrett’s syndrome are the same.

5 Leading Approaches to Diagnosing GERD

In most cases, a patient’s first course of GERD treatment will involve lifestyle changes, followed by medication that can either block acids from entering the esophagus or reduce acid production. However, diagnosing GERD should be the first step, as a doctor’s diagnosis will determine the underlying cause of your symptoms.

Among the leading methods for diagnosing GERD:

• Upper endoscopy – This minimally invasive technique enables a live viewing into your esophagus, stomach, and (potentially) upper small intestine through a camera-equipped, flexible device called an endoscope. While lying on your side, the gastroenterologist gently inserts the slim endoscope through your mouth toward your stomach as the lighted camera feeds images to a monitor that your doctor analyzes for inflammation and other complications. During this procedure, you will be medicated to relax or sleep, so you might require a ride home. Also, you will need to fast for at least six hours beforehand. Read more about upper endoscopy for diagnosing GERD here.
• Esophageal manometry – This method for diagnosing GERD measures esophageal muscle strength and coordination, including that of the lower esophageal sphincter, as well as contractions when you swallow. It is performed using a slim, flexible tube that is eased through your nose (you will be given a numbing agent). As the tube slowly approaches your stomach, sensors attached to the tube will record pressure levels from your esophagus to the sphincter while you swallow. It sends the live readings to a computer for the gastroenterologist to read. During this part, you will need to be very still. You can learn more about esophageal manometry here.
• Capsule endoscopy – Another approach to viewing the inside of the upper GI tract, a capsule endoscopy employs an actual small capsule containing a tiny, wireless camera. After you swallow the clear capsule, the camera takes thousands of images and sends them to a portable recorder you’ll be instructed to wear. (Often, your gastroenterologist prescribes this GERD diagnosis to view your small intestine.) The capsule is disposable and will pass in a bowel movement, while you return the portable recorder to the doctor for analysis. Visit our capsule endoscopy website here.
• Ambulatory acid (pH) probe test – This approach to diagnosing GERD measures the frequency, amount, and duration of stomach acid regurgitating into the esophagus. It works using a tiny device, called a pH probe, that is temporarily installed in the esophagus and connected to a small computer you will wear for 24 to 96 hours, during which the probe measures acid level activity.

Imaging technology – A non-invasive diagnostic procedure in which X-rays capture images of your upper digestive system after drinking barium. This chalky liquid is opaque to X-rays and therefore can silhouette the digestive tract.

If you receive a GERD diagnosis and medication fails to relieve your symptoms, your physician may recommend a surgical specialist to perform a number of procedures designed to strengthen the sphincter between the stomach and esophagus.

If your GERD has advanced and the esophageal tissue cells have begun to mimic those of the stomach, you can consider these advanced GERD treatments for Barrett’s esophagus.

What You Can Do at Home After Diagnosing GERD

If you live with any of the above risk factors for GERD, alleviating those behaviors could also help reduce the likelihood of reflux.

Among suggested home-based practices for GERD:

• Adjust your menu and use smaller plates. Say no to acidic, spicy, and greasy foods, including tomato-based dishes, citrus fruits, fatty foods, carbonated beverages, and chocolate. Additionally, eating smaller meals can benefit you because they digest more quickly, require your stomach to produce less acid, and do not expand your stomach and put pressure on your sphincter like large meals do.
• Wait three hours, then turn left. Try eating your final meal at least three hours before you go to bed, to give gravity a better chance at holding acids down. Some researchers advise sleeping on your left side because it positions the sphincter above your stomach’s contents, avoiding exposure.
• Reduce (or quit) nicotine and alcohol. Both smoking and drinking alcohol can slow digestion and make your stomach more acidic. GERD-friendly beverages include non-citrus fruit and vegetable juices, iced and hot tea (ginger tea can even reduce symptoms), and water.
• Maintain a healthy weight. Too much abdominal pressure from excess weight can stretch and weaken the muscles supporting your lower esophageal sphincter. If you are overweight, wear clothing that does not restrict your waistband.

In all of the above, ask your doctor for guidelines.

If you are among the 20% of people believed to have GERD, know that you have very high odds of reducing your symptoms and maintaining the lifestyle you prefer. It takes dedication, and it might require medical intervention, but you do have options.

Learn more about your options for diagnosing GERD and treatments here. Or simply click here to request an appointment at Cincinnati GI.