Investigations

Diagnosis is usually based on the clinical presentation.

Investigations used for GORD include:

• barium contrast radiography - can be used to evaluate the presence of anatomical abnormalities of the gastrointestinal tract. E.g. - esophageal stricture, pyloric stenosis, intestinal malrotation, tracheoesophageal fistula, hiatal hernia
• pH studies, which monitor the pH in the lower oesophagus and can thus demostrate the amount of reflux the frequency and duration of reflux (1)
• upper GI endoscopy and biopsy – can evaluate the oesophageal mucosa for features associated with GORD (esophagitis, erosions, exudate, ulcers, strictures)
• radioisotope studies may be valuable in identifying the severity of the reflux and establishing the presence of aspiration (1).

Reference:

• (1) Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Journal of Pediatric Gastroenterology and Nutrition 2009; 49:498–547