If no significant relief in your symptom complex is noted after several weeks, and/or there continue to be significant clinical signs of persistent reflux damage, you may be referred for more extensive testing and management. Within this practice, we are able to offer the most advanced testing available in this regard including esophageal manometry as well as 24 hour pH testing including impedance which is able to detect the presence of non-acid reflux events. We are proud to specialize in comprehensive reflux evaluation and management and will refer you to outside physicians as necessary to best manage your reflux.

Uncontrolled reflux/excessive acid production has been linked to several serious health conditions including stomach ulcers, Barrett’s esophagus and even cancer. For this reason, it is important to follow-up with the recommendations for further evaluation of your reflux.

common tests to evaluate reflux

One or more of the tests listed below, may be ordered by the specialists you are referred to by this office. It is important to proceed with this testing in order to more thoroughly evaluate the cause and severity of your reflux so that it is properly managed in the best way possible.

Barium Swallow


​This is typically an initial step in further evaluating your reflux. This examination is conducted using fluoroscopy, a type of “movie” X-ray. For this examination, you will be given liquid barium to drink, as well as effervescent crystals and a barium tablet. This test examines the movement of the barium contrast through the esophagus, evaluating for function, movement and anatomical abnormalities. If no reflux is documented during this examination, it does not mean you do not experience reflux at other times, with different stomach contents.

EGD (EsophagoGastroDuodenoscopy)


​This procedure is typically conducted under sedation, requiring someone to drive you following the appointment. For this examination, an endoscope is passed through the mouth, into the esophagus, stomach, and duodenum. During this examination, these structures are examined for anatomical abnormalities as well as signs of reflux and/or acid damage to these structures. If abnormalities are seen, biopsies are typically taken for further pathologic analysis. This test does not assess the function of these structures (i.e., how ell they do/don’t work), but rather the integrity or health of the structures.

pH Testing


​This test assesses the acid levels at various points within the upper digestive tract. If you are taking acid-controlling medications, you will be asked to stop using these for several days prior to the examination to ensure an accurate test result. For this test, a probe is placed within the tract and kept in place, typically for 24 hours. During this time, you are instructed to eat normally, following your regular routine as much as possible. This test assesses how much acid exists and where it is detected within the upper GI tract, determining how frequently reflux occurs and at what level of the upper GI tract. This test is extremely valuable in determining how significant your reflux issue may be.

Esophageal Manometry and Motility Testing


​This test is helpful in determining if you esophagus is moving as it should. A peristalsis, or wavelike contraction of the esophagus should occur after food is swallowed, helping to move food from the throat, through the esophagus and into the stomach. If the esophagus is not working properly, this could be contributing to your reflux issue. It is also important in determining appropriate treatment options for you.

After testing


​The specialist will discuss with you the results, the severity of your reflux as well as appropriate management options that will be in the best interest of your overall health. If further interventions by these specialists will be conducted, this practice will provide surveillance for the reflux as it impacts the throat, although allowing these specialists to continue your reflux management.