Diagnosis of GER & GERD in Children

How do doctors diagnose GER and GERD in children?

In most cases, doctors diagnose gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) by reviewing a child’s symptoms and medical history. If symptoms suggest GERD, doctors may recommend treatment with lifestyle changes or medicines, instead of doing tests.

Doctors may recommend medical tests if symptoms suggest that a child may have a health problem other than GERD or a complication of GERD. Doctors may also recommend tests if symptoms don’t improve with lifestyle changes or medicines.

Doctors may refer a child to a pediatric gastroenterologist to diagnose and treat GERD.

In most cases, doctors diagnose GER and GERD by reviewing a child's symptoms and medical history.

What tests do doctors use to diagnose GERD?

Doctors may order one or more of the following tests to help diagnose GERD and check for other health problems.

Upper gastrointestinal (GI) endoscopy

Upper GI endoscopy is a procedure in which a doctor uses an endoscope—a flexible tube with a camera—to see the lining of the upper GI tract, including the esophagus, stomach, and duodenum. During upper GI endoscopy, a doctor may obtain biopsies by passing an instrument through the endoscope to take small pieces of tissue from the lining of the esophagus. A pathologist will examine the tissue under a microscope. Doctors may order an upper GI endoscopy to check for problems other than GERD or complications of GERD.

Esophageal pH monitoring

Esophageal pH monitoring is the most accurate way to detect stomach acid in the esophagus. Two types of esophageal pH monitoring are

• catheter monitoring, in which a health care professional passes one end of a catheter—a thin, flexible tube—through the nose and into the esophagus to measure acid reflux. Health care professionals sometimes combine this test with an impedance monitoring test, which can detect nonacid reflux, during the same procedure.
• capsule monitoring, in which a health care professional uses an endoscope to place a small, wireless capsule on the lining of the esophagus to measure acid reflux.

The child wears a monitor that receives information from the catheter or capsule. During esophageal pH monitoring, a parent or caregiver tracks information about the child’s diet, sleep, and symptoms. The doctor uses this information to see how diet, sleep, and symptoms relate to reflux in the esophagus. Doctors may order this test to confirm the diagnosis of GERD or to find out if GERD treatments are working.

Upper GI series

An upper GI series is a procedure in which a doctor uses x-rays and a chalky liquid called barium to view the upper GI tract. Doctors may order this test to check for problems, such as anatomic problems in the upper GI tract, that may be causing or worsening symptoms.