These drugs include cisapride, bethanechol, and metoclopramide. A small number of people with GERD may need surgery because of severe reflux and poor response to medical treatment. Fundoplication is a surgical procedure that increases pressure in the lower esophagus. However, surgery should not be considered until all other measures have been tried. Symptoms People with severe, chronic esophageal reflux or with symptoms not relieved by the treatment described above may need more complete diagnostic evaluation.
Physicians use a variety of tests and procedures to examine a patient with chronic heartburn.
An upper GI series may be performed during the early phase of testing. While an upper GI series provides limited information about possible reflux, these tests can rule out other diagnoses, such as peptic ulcers. This test attempts to confirm that the symptoms result from acid in the esophagus. For patients who present a difficult diagnosis, physicians may measure the acid levels inside the esophagus through pH testing. Testing pH monitors the acidity level of the esophagus and symptoms during meals, activity, and sleep.