How is GERD diagnosed?

Most of the time, the physician can make a diagnosis by interviewing the caregiver and examining the child. On occasions, testing is recommended. The tests that are most commonly used to diagnose gastroesophageal reflux include:

  • pH probe: A small wire with an acid sensor is placed through the nose down to the bottom of the esophagus. The sensor can detect when acid from the stomach is “refluxed” into the esophagus. This information is generally recorded on a computer. Usually, the sensor is left in place from 12 – 24 hours. At the conclusion of the test, the results indicate how often the child “refluxes” acid into his or her esophagus and whether he or she has any symptoms when that occurs.
  • Barium swallow or upper GI series: The child is fed barium – a white, chalky, liquid – and a video x-ray machine follows the barium through the upper intestinal tract so doctors can see if there are any abnormal twists, kinks, or narrowing in the upper intestinal tract.
  • Technetium gastric emptying study: The child is fed milk mixed with technetium, a very weakly radioactive chemical, and the technetium is followed through the intestinal tract using a special camera. This test is helpful in determining whether some of the milk/technetium ends up in the lungs. It may also be helpful in determining how long milk sits in the stomach.
  • Endoscopy with biopsies: This most comprehensive test involves the passing down of a flexible endoscope with lights and lenses through the mouth into the esophagus, stomach, and duodenum, allowing the doctor to check for any irritation or inflammation. In some children, repeated exposure of the esophagus to stomach acid causes some inflammation (esophagitis). Endoscopy in children usually requires a general anesthetic.
  • Fiberoptic Laryngoscopy: A small lighted scope is placed in the nose and the pharynx to evaluate for inflammation.
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