It is important to diagnose other diseases, some of which are life threatening that can mimic GERD. A cardiac workup and gallbladder ultrasound for instance could be considered.
An upper GI x-ray looks at the anatomy and function of the esophagus and stomach, and can be helpful.
An upper endoscopy of the esophagus and stomach is a critical part of the evaluation of patients with GERD. Its main aim is to detect complications of GERD, the presence of which often influences therapeutic decisions.
A 24-hour pH monitor is considered by many to be the gold standard for the diagnosis of GERD and has the highest sensitivity and specificity of all tests currently available. Some have suggested that 24-hour pH monitoring be used selectively, limiting its use to patients with atypical symptoms and/or no endoscopic evidence of GERD. More than half of the patients currently referred for an anti-reflux operation will have no endoscopic evidence of muscosal injury. For these patients, 24-hour pH monitoring provides the only objective measure of the presence of pathologic reflux.