You may also undergo a test to see how much acid is in your esophagus. An endoscopy, which uses a flexible tube containing a tiny camera to examine your throat, may be used to help confirm your diagnosis, or if your doctor suspects that your GERD has caused further complications. Other tests may be recommended if your doctor isn’t sure your symptoms are caused by GERD, or if certain complications may be present. (1) Common symptoms include:

Frequent heartburn, a burning feeling in your chest or throatRegurgitating food or stomach contentsSore throatDifficulty swallowing (dysphagia)Feeling like there’s a lump in your throatDamaged teeth from stomach acidChest painBad breathNauseaVomiting (2,3)

Certain symptoms may also come from respiratory complications of GERD, which happen when you breathe stomach acid into your lungs. These symptoms can include:

Asthma, a chronic disease characterized by sensitivity to lung irritantsChest congestionA dry cough that doesn’t go awayWheezing, or constricted breathing that causes a high-pitched soundHoarseness or partial loss of your voiceLaryngitis, or swelling of your voice box, which can cause temporary loss of your voicePneumonia, or lung infection (3)

If you have acid reflux at night, you may experience disrupted sleep or be at higher risk for respiratory complications of GERD. (2)

Heartburn or Heart Attack?

People with GERD often report chest pain, commonly known as heartburn. People who are having a heart attack — or certain other heart problems — also often experience chest pain. Chest pain caused by reduced blood flow to your heart is called angina. It’s important to make sure your chest pain isn’t being caused by a heart problem before focusing on a diagnosis of GERD. Chest pain caused by a heart attack is more likely to include:

Pressure or squeezing in your chest, arm(s), neck, jaw, or backNauseaCold sweatsShortness of breathDizziness or light-headednessFatigue

A telltale sign of heartburn is that it generally doesn’t get worse with activity or better with rest. If you have severe, crushing chest pain — or pain in your left arm or jaw — seek emergency medical attention, since it may indicate a heart attack. If you have chest pain and aren’t sure what’s causing it, you should also seek emergency medical attention. (4)

Tests for GERD

Most of the time, a diagnosis of GERD isn’t based on any medical test or procedure, but instead on your symptoms. Your doctor may prescribe a medication to see if it reduces your symptoms. If it does, this will most likely confirm your diagnosis of GERD. In some cases, though, your doctor may want to perform an additional test or procedure to confirm or rule out a GERD diagnosis. Diagnostic tests for GERD include:

Ambulatory Acid Probe

Also called a pH probe, this test uses a device to measure the amount of acid in your esophagus. A monitor connected to a flexible tube will be threaded through your nose into your esophagus. It will connect to a small data recorder on the outside, which you’ll wear around your arm or waist. It’s left in place for 24 hours or longer. Alternatively, the monitor may be a clip that’s placed in your esophagus. This clip will pass through your digestive system into your stool after a couple of days.

Upper Endoscopy

In this procedure, your doctor inserts a thin, flexible tube containing a camera down your throat to examine your esophagus and assess how badly it’s been damaged. As part of this procedure, your doctor may take a biopsy (small tissue sample) from the lining of your esophagus. This tissue will be examined in a lab for abnormalities. This test can show normal results even when acid reflux is present. It’s often used to look for complications of GERD, such as inflammation, ulcers, or a precancerous condition called Barrett’s esophagus. If you show signs of Barrett’s esophagus, your doctor may want you to get regular endoscopy exams.

Esophageal Manometry

This test measures muscle contractions in your esophagus. It uses a device attached to a long, thin tube that’s passed through your nose into your stomach, then slowly back up through your esophagus. This procedure can show whether your GERD is due to a weak lower esophageal sphincter, the ring of muscle between your stomach and esophagus. It can also help diagnose problems with your esophagus other than GERD.

Upper GI Series

This test uses X-rays to look at your upper digestive tract. While you stand or sit in front of an X-ray machine, you’ll drink a chalky liquid containing barium, which coats the lining of your esophagus and stomach. The X-ray technician will take several images as the liquid moves through your system. This procedure can help detect strictures or ulcers in your esophagus, or a hiatal hernia, when the upper part of your stomach pushes up through the opening in your diaphragm for your esophagus. (2,3) Additional reporting by Quinn Phillips