Acid reflux and its long-term form, gastroesophageal reflux disease (GERD), are becoming more common in Singapore. This rise is influenced by lifestyle factors such as diet, stress and late-night eating, as well as increasing rates of obesity.
Unlike occasional heartburn, GERD is a chronic condition where stomach acid repeatedly flows back into the oesophagus. This can lead to symptoms such as regurgitation, chest discomfort and difficulty swallowing. When these symptoms occur frequently, they can disrupt daily life and affect overall well-being. Identifying GERD early through appropriate diagnostic tools allows treatment to be tailored effectively and helps reduce the risk of long-term complications.
In this article, we look at the diagnostic tests commonly used to evaluate GERD and when each may be recommended—read on to learn more.
6 Recommended Diagnostic Tools for GERD
Doctors use a range of diagnostic methods to confirm GERD and rule out other conditions with similar symptoms. Below are six commonly used tools and how they contribute to diagnosis.
Clinical Diagnosis
An assessment often begins with a detailed discussion of your symptoms and medical history. Your doctor may ask about heartburn, regurgitation, chest discomfort or swallowing difficulties, as well as when these symptoms occur.
Keeping a symptom diary—or using digital health apps—can be particularly helpful, as it allows patterns to be identified and supports more targeted treatment planning.
Upper Gastrointestinal Endoscopy (Gastroscopy)
Gastroscopy involves inserting a thin, flexible tube with a camera through the mouth to examine the oesophagus and stomach. This test allows doctors to spot irritation, inflammation or any damage caused by acid reflux.
Although highly informative, gastroscopy is invasive and not required for every patient. It is usually recommended only when symptoms are severe, persistent or when complications are suspected.
Oesophageal pH Monitoring
This test measures acid levels in the oesophagus over 24 to 48 hours. It uses either a thin catheter or a small wireless capsule placed temporarily in the oesophagus. Oesophageal pH monitoring is highly accurate, making it useful when symptoms are unclear or when doctors need to assess how well treatment is working.
Oesophageal Impedance-pH Monitoring
Impedance-pH monitoring goes a step further by detecting both acid and non-acid reflux. This makes it especially helpful for individuals who still experience symptoms despite taking acid-suppressing medications.
In Singapore, this advanced test is usually performed at specialised gastroenterology centres when standard pH monitoring does not fully explain persistent symptoms.
High-Resolution Manometry (HRM)
HRM measures the strength and coordination of muscle contractions in the oesophagus. Although it does not diagnose GERD directly, it helps identify other motility or swallowing disorders that can mimic GERD. In complex cases or when the diagnosis is unclear, HRM is an important complementary tool.
Barium Swallow
A barium swallow is a simple imaging test in which patients drink a liquid that coats the oesophagus and stomach, making them visible on X-rays. It can reveal structural problems such as strictures or narrowing. However, the barium swallow is now used less frequently because newer tests like pH and impedance-pH–pH monitoring offer more precise information.
When to Seek Diagnosis for GERD
While occasional heartburn is common, certain symptoms should prompt a medical evaluation. We recommend you seek a diagnosis if you experience:
- Persistent heartburn
- Frequent acid regurgitation
- Ongoing chest discomfort
- Difficulty swallowing
If these symptoms occur regularly or continue despite lifestyle changes or over-the-counter medication, they may indicate underlying reflux-related complications. Early assessment allows your doctor to identify the cause and intervene before symptoms worsen.
A Clear Diagnosis for More Effective Treatment
Proper diagnosis is the foundation of effective GERD management. By understanding the exact cause of your discomfort, you and your doctor can choose the most suitable treatment approach and reduce the risk of long-term complications.
For ongoing reflux symptoms, consider arranging a consultation with our doctor for a thorough evaluation and personalised advice. Contact us today.