Diagnosing GORD

The symptoms of heartburn or gastro-oesophageal reflux disease (GORD) are normally so obvious that tests are not required.

However, if the doctor is in doubt, or if the symptoms are very troublesome, he or she might recommend a gastroscopy or upper endoscopy (commonly known as “swallowing the camera”). This is to establish whether or not the patient has oesophagitis, hiatus hernia, peptic ulcer or any other condition.

A gastroscopy is an examination of the inside of the oesophagus, stomach and duodenum. The doctor passes a thin, flexible instrument through the patient’s mouth, down the oesophagus and into the stomach. This allows the doctor to see whether there is any damage to the lining of the oesophagus or stomach and whether there are any ulcers in the stomach or duodenum.

The procedure is painless and performed under a light sedative.

Other diagnostic procedures include a barium swallow, a 24-hour oesophageal study and an oesophageal manometry. The last test is usually reserved for patients where the diagnosis is unclear or where surgery is being considered, and will help to determine how well the sphincter is functioning.

Other conditions with symptoms similar to heartburn/gastro-oesophageal reflux:

  • Gallstones: These are best diagnosed with an ultrasound scan.
  • Ulcers: These may occur in the stomach or the duodenum or oesophagus. They may give symptoms similar to heartburn. Occasionally, they may rupture or bleed, leading to severe pain. Diagnosis is by gastroscopy.
  • Heart pain: Angina is pain due to heart strain. It usually comes on while you are exercising. If angina becomes more severe, the pain can occur at rest as well. If the pain travels down the arm, a doctor should be contacted immediately.
  • Gastritis: Generalised inflammation of the stomach lining may be caused by aspirin or anti-inflammatory drugs.

    Previously reviewed by Dr Ganief Adams, Gastroenterologist, MBChB (UCT), FCP (SA)

    Reviewed by Dr Jenny Edge, General Surgeon, BSc, MB BS, FRCS (Edin), M Med (Stell.)
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