Diagnostic Tools for GERD

About the Author

Dr Rajkumar JS


Dr JS Rajkumar is the Chief Surgeon with LIMA.

Symptoms of GERD can be confusing. So using proper diagnostic tools is rather important correctly diagnosing GERD. Here are the three questions we try to find answers for when you come to us for GERD treatment. The course of the treatment is decided based on what the investigation shows.

1. Does the patient have GERD?

The commonest diagnostic test carried out to ascertain presence of GERD is upper GI endoscopy, wherein we insert a video camera into the esophagus and look for erosion and ulcers caused by the acid attack. This test is accurate in about 7 out of 10 cases.

Whereas, 3 out of 10 GERD patients have normal looking inner lining. This condition is called ENRD (Endoscopy Negative Reflux Disease) or NERD (Non-Erosive Reflux Disease). Therefore, if you have symptoms of GERD, don’t ignore them just because your endoscopy is normal.

Go to our page on upper GI endoscopy for a detailed description of how this diagnostic exercise is carried out.

2. How much acid really goes across the valve?

To answer this question, the most efficient single tool is the 24 hours ambulatory pH study (ambulatory = adapted to walking around with).   In this test, we pass special thin tubes through the nose to sit in the gullet and the stomach. Electronics attached to the other end of the tubes record the amount of acid that goes back across the valve <more details please>.

While the endoscopy is a quality tool, the 24 hour pH study is a quantitative tool that permits us to quantify the amount of reflux across the lower esophageal sphincter.

As per the international quantification <reference needed>, total time length of reflux over a 24 hour period classifies the disease as under:

  • <4% is normal
  • 4% ~ 8% is considered a mild disease
  • 8% to 20% is considered a moderate disease
  • >20% is considered a severe disease.

Go to our page on 24 hour pH study for a details discussion on this diagnostic tool.

3. How is a Treatment Option Selected?

Before we operate on a patient, we study the esophagus through a manometry. A manometry shows how efficiently the patient is able to move the food along the food pipe. If the manometry shows that the patient has a weak esophagus, we fine tune the surgery so that the patient will not have swallowing difficulty post-operatively.

Go to our page on manometry for a detailed discussion on this diagnostic tool.

Unless the patient has an unusual condition, no other diagnostic tools for fundoplication is considered relevant.

GERD/LPR Expertise at LIMA

  • Our Chief Surgeon Dr. J. S. Rajkumar had authored a text book titled Modern Methods for Managing Acid Reflux/GERD. All the knowledge he used in writing this textbook are now incorporated in LIMA’s practice.
  • LIMA has all the instrumentation needed to accurately investigate and assess how mild or severe your acid reflux is
  • LIMA consultants offers the full range of Acid Reflux/GERD treatment, including
    • Behavior modification experts to help you with lifestyle changes
    • Registered dieticians to help you with a suitable diet selection
    • Functional medicine doctors to help you with nutritional support
    • Gastroenterologists to help you with medical protocol
    • The surgical group that has handled more volume than anyone else in South India

If the nature of your GERD is such that it doesn’t respond satisfactorily for lifestyle, dietary or medical interventions, then a surgical solution is your best option. If you select surgery, LIMA can give you “unparalleled advantage”:

  • Till date, we have carried out more than 2,000+ fundoplication surgeries. This is the largest volume handled by any single surgical team in South India.
  • LIMA is the only center in the Chennai where you can get the surgery done through a Scarless procedure.
  • LIMA subsidiary, MISTY, has trained largest number of surgeons in the country for
  • Currently, Dr. J. S. Rajkumar is co-authoring the first and only manual for laparoscopic surgery (14 volumes)


Listen to some of our real patients who received acid reflux/GERD treatment at LIMA:

Testimonial Videos

Even more Education

If you have read this far, we must congratulate you. You have taken your first step towards becoming an intelligent and informed patient. Very few patients have so much of dedication or put in the necessary efforts to empower themselves with the right kind of knowledge. Here are a few things you can do to further your knowledge:

  • Enroll yourself in our free newsletter about Acid Reflux/GERD management
  • Download our free ebook on Acid Reflux/GERD
  • Download our free ebook on Indian diets for GERD
  • LIKE our Facebook page on Acid Reflux/GERD to receive daily updates on this disease
  • LIKE our LIMA Facebook page to updates on other cutting edge treatments available only at LIM

Meet a Doctor

Do you think you have some of the symptoms described here. Fix an appointment with a LIMA doctor and get a thorough investigation. Unlike other chronic diseases, GERD can be easily treated if you catch it before it turns malignant.

Free eBook on GERD

Do you or someone you love has GERD (Acid Reflux). Download our free eBook specially prepared for the Indian patient, written by highly accomplished Indian surgeons, who have published several books for the international audience.

Knowledge base discussions

Go to the GERD/Acid Reflux page on our forum. Questions that patients like you asked and answers they received from LIMA or from other patients are permanently here, just frozen in time, waiting for you to benefit from the collective wisdom.