Gastroesophageal Reflux Disease (GERD) | Diagnosis and Treatment

How is GERD diagnosed?

In order to properly diagnose your child’s condition, your doctor may recommend one or more of the following procedures:

  • High-resolution esophageal manometry: A thin tube is inserted through the nose or mouth into the esophagus to measure the pressure within the esophagus and the lower esophageal sphincter.
  • Endoscopy: This procedure involves the use of a thin and lighted tube placed through the nose or mouth into the esophagus to "see" inside the esophagus.
  • pH impedance testing: An impedance study (with pH monitoring) evaluates acid and non-gastroesophageal reflux to determine if contents from the stomach are leaking into the esophagus (food tube) and are associated with symptoms.
  • BRAVO® placement: During this test, we attach a wireless capsule to the esophagus to record what the acid does inside the body.
  • Upper GI (gastrointestinal) endoscopy: In this test, a flexible tube is placed from the mouth into the stomach. This allows visualization and sampling (biopsies) of the different organs to see if there is underlying inflammation or a reason for the GERD symptoms.
  • Upper GI series: This test examines the organs of the upper part of the digestive system using barium, a radio-opaque liquid that coats the inside of organs so that they will show up on an x-ray.
  • Gastric emptying studies: These tests determine whether or not the stomach contents empty into the small intestine properly. Delayed gastric emptying can contribute to GERD, allowing stomach contents to back up into the esophagus.

How is GERD treated?

GERD treatment varies with age. The first step in treating normal reflux in infants is to look for solutions that do not require the use of medication. Your gastroenterology specialist may recommend trying different ways of positioning and feeding your infant.

Many babies with GER will outgrow it by the time they are about one year old, as the lower esophageal sphincter becomes stronger. For others, medications that take away the stomach acid, or make the stomach empty faster, can minimize reflux, vomiting and heartburn. Lifestyle and dietary changes may also help.

For more severe cases, we provide advanced therapies not routinely available. We may recommend surgery to reinforce the lower esophageal sphincter and mechanically discourage reflux.

For patients with GERD that have undergone surgery and continue to have problems, we offer a series of specialized treatments that include medications to relax the stomach, such as injections of Botox or medications to improve gastric emptying and help reduce pain.