Esophageal manometry: Mandatory
Ambulatory 24-hour pH monitoring: Criterion standard in establishing a diagnosis of gastroesophageal reflux disease
Upper gastrointestinal endoscopy/esophagogastroduodenoscopy: Mandatory
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.
Chest images may also demonstrate a large hiatal hernia, but small hernias can be easily missed.
Currently, no role exists for computed tomography scanning, magnetic resonance imaging, or ultrasonography in the routine evaluation of patients with reflux disease.
