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Diagnostic Tests for Heartburn

Diagnostic Test list for Heartburn:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Heartburn includes:

  • Physical examination
    • Look for evidence of anemia - e.g. pale skin and conjunctiva - may suggest chronic oesophagitis, chronic gastritis, peptic ulcer or stomach cancer.
    • Look for evidence of jaundice - e.g. yellow skin and sclera of eyes - may suggest gallstones that pass into common bile duct or cancer of the pancreas.
    • Abdominal examination for tenderness - e.g. tenderness in epigastric area (midline below ribs) may suggest peptic ulceration; tenderness over the right upper abdomen may suggest gall bladder disease.
    • Abdominal examination for mass - e.g. epigastric mass may suggest stomach cancer.
  • Blood tests
    • Full blood count and ESR
    • Iron studies
    • Electrolytes and renal function (especially if persistent vomiting as renal failure can present with dyspepsia and vomiting)
    • Liver function tests
    • Helicobacter pylori serology (to test for presence of bacteria that is now accepted to cause duodenal ulcers, but does not distinguish fro past or present infection)
    • Gastrin levels, if multiple peptic ulcers to help diagnose Zollinger-Ellison syndrome
    • Tumor markers including Carcinoembryonic antigen (for bowel cancer) and alphafetoprotein (for hepatoma)
  • Stool occult blood test - may be positive with peptic ulcer, oesophagitis, stomach cancer.
  • Exercise ECG - may be required to rule out ischemic heart disease.
  • Radiological investigations
    • Abdominal ultrasound scan - can give information about the liver, bile ducts, pancreas, kidneys. This is the best test for gallstones.
    • CT Scan abdomen if ultrasound suggests pathology but undefined
    • HIDA scan can exclude an obstructed bile duct
    • Barium swallow and barium meal can diagnose esophageal motility disorders and obstruction of the upper gastrointestinal tract
    • Scintographic gastric -emptying studies may help to diagnose delayed gastric emptying e.g. in diabetes
    • ERCP, if jaundiced, which provides information about the bile ducts
  • Urea breath test - test of choice for following the response to treatment of Helicobacter pylori.
  • Upper gastrointestinal endoscopy (with biopsy of mass if found and for Helicobacter pylori) - may be required to diagnose peptic ulcers, stomach cancer.
  • ERCP, if jaundiced
  • PH monitoring of the distal esophagus
  • Manometry studies may be useful if investigating difficulty with swallowing

Home Diagnostic Testing

These home medical tests may be relevant to Heartburn causes:

Tests and diagnosis discussion for Heartburn:

If your heartburn does not improve with lifestyle changes or drugs, you may need additional tests.

  • A barium swallow radiograph uses x rays to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus. With this test, you drink a solution and then x rays are taken. Mild irritation will not appear on this test, although narrowing of the esophagus--called strictures--ulcers, hiatal hernia, and other problems will.

  • Upper endoscopy is more accurate than a barium swallow radiograph and may be performed in a hospital or a doctor's office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube called an endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm GERD.

    The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found.

  • In an ambulatory pH monitoring examination, the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. While you go about your normal activities, it measures the amount of and when acid comes up into your esophagus. This test is useful in people with GERD symptoms but no esophageal damage. The procedure is also helpful in detecting whether respiratory symptoms, including wheezing and coughing, are triggered by reflux.

(Source: excerpt from Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD): NIDDK)

Conditions listing medical symptoms: Heartburn:

The following list of conditions have 'Heartburn' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Heartburn or choose View All.

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Conditions listing medical complications: Heartburn:

The following list of medical conditions have 'Heartburn' or similar listed as a medical complication in our database.

 

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