Diagnosing gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a common condition with a variety of clinical manifestations and potentially serious complications. This art icle reviews available methods for diagnosing GERD, A clinical history of t he classic symptoms of GERD, heartburn or acid regurgitation, is sensitive enough to establish the diagnosis in patients without other complications. Esophagogastroduodenoscopy is the best way to evaluate suspected complicati ons of GERD, but endoscopic findings are insensitive for the presence of pa thological reflux, and therefore they cannot reliably exclude GERD, The "go ld standard" study for confirming or excluding the presence of abnormal gas troesophageal reflux is the 24-hour ambulatory esophageal pH monitoring tes t, and this study should be used far the evaluation of refractory symptoms and extraesophageal manifestations of GERD, A formal acid-suppression test is helpful in the evaluation of the atypical GERD symptom of noncardiac che st pain. Optimal use of currently available tests for GERD may allow for mo re efficient diagnosis and better characterization of the pathological mani festations associated with GERD.