What is the primary method for diagnosing GERD?

The primary method for diagnosing gastroesophageal reflux disease (GERD) is upper gastrointestinal endoscopy with biopsy. This technique allows direct visualization of the esophagus and stomach, providing insight into any structural or mucosal abnormalities. It is particularly useful in assessing complications of GERD, such as esophagitis, strictures, or Barrett's esophagus.

During the procedure, a flexible endoscope is inserted through the mouth to view the upper digestive tract. If any abnormal areas are found, a biopsy can be performed to evaluate for conditions like inflammation or dysplasia, which may indicate chronic reflux or potential progression to cancer. This direct approach is considered the gold standard as it can often provide definitive evidence of GERD and rule out other possible causes of symptoms.

While pH monitoring is another effective method for diagnosing GERD and can quantify acid exposure in the esophagus, upper GI endoscopy provides a broader diagnostic scope and immediate clinical findings. Techniques like esophageal manometry primarily assess motility and are not typically used alone for diagnosing GERD. GI radiography with contrast can show reflux or anatomical issues but lacks the detail and diagnostic accuracy provided by endoscopy.