Your doctor or gastroenterologist may wish to evaluate your symptoms with additional tests when it is unclear whether your symptoms are caused by acid reflux, or if you suffer from complications of GERD such as dysphagia (difficulty in swallowing), bleeding, choking, or if your symptoms fail to improve with prescription medications. Your doctor may decide to conduct one or more of the following tests.

Upper GI Series
For the upper GI series, you will be asked to swallow a liquid barium mixture (sometimes called a "barium meal"). The radiologist uses a fluoroscope to watch the barium as it travels down your esophagus and into the stomach.

You will be asked to move into various positions on the x-ray table while the radiologist watches the GI tract. Permanent pictures (x-ray films) will be made as needed.

Endoscopy
This test involves passing a small lighted flexible tube through the mouth into the esophagus and stomach to examine for abnormalities. The test is usually performed with the aid of sedatives. It is the best test to identify esophagitis and Barrett's esophagus.

Esophageal Manometry or Esophageal pH
This test involves passing a small flexible tube through the nose into the esophagus and stomach in order to measure pressures and function of the esophagus. Also, the degree of acid refluxed into the esophagus can be measured over 24 hours.