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1. Testing: The following studies are used to evaluate patients with suspected gastroesophageal reflux disease:
2. Imaging studies

Upper gastrointestinal contrast-enhanced studies are the initial radiologic procedure of choice in the workup gastroesophageal reflux disease. Plain chest radiographic findings are not useful in the evaluation of this condition, but they are helpful in assessing the pulmonary status and basic anatomy.

Currently, no role exists for computed tomography scanning, magnetic resonance imaging, or ultrasonography in the routine evaluation of patients with reflux disease.

Chest images may also demonstrate a large hiatal hernia, but small hernias can be easily missed.

Ambulatory 24-hour pH monitoring: Criterion standard in establishing a diagnosis of gastroesophageal reflux disease

Esophageal manometry: Mandatory

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy: Mandatory