Resources
If you have frequent acid reflux or have reflux symptoms that are not improving with basic lifestyle and diet changes, your primary care clinician may recommend seeing a gastroenterologist. A gastroenterologist is a medical specialist who focuses on digestive conditions, like GERD, IBS, SIBO, and esophageal disorders. Knowing what to expect can help reduce anxiety, make the appointment more productive, and help inform your questions ahead of time.
There are a number of reasons a person dealing with acid reflux may be referred. A specialist visit is often recommended for reasons like:
• Persistent reflux despite lifestyle adjustments, diet changes, or medication
• Reflux symptoms that quickly return when medication is stopped
• Difficulty swallowing, digestive-related chest discomfort, or a chronic cough
• Nighttime reflux
• A family history of esophageal conditions
• Unexplained weight loss
As specialists, gastroenterologists can help evaluate the root cause of one's reflux and create a personalized treatment plan. While appointments can vary a little depending on the person, working with a gastroenterologist tends to be a standard process.
Preparing ahead of time for the appointment can make it more productive. Consider bringing things like a list of your symptoms, a list of current medications, any recent test results, a food or symptom journal, and specific questions you want answered.
The more information you provide, the easier it usually is for the gastroenterologist to find patterns and tailor the treatment plan.
Initially, the gastroenterologist will want to discuss your reflux symptoms. You can expect them to ask about things like:
• How often symptoms occur, and if they happen at night
• What symptoms feel like
• How long you have had symptoms
• Whether certain foods trigger reflux episodes
• What treatments you have already tried
• Your general medical history
Be as specific as possible. Any notes or symptom diary you bring can help you communicate more accurately as well. Remember, the gastroenterologist's job is to help you, so be as open as you are comfortable with.
The gastroenterologist may want to do a quick physical exam, as this can help them identify clues about your digestive health. It may include checking your throat for irritation or lightly pressing on the abdomen to check for tenderness. The exam is usually brief and comfortable.
The gastroenterologist will also probably review your current daily habits, medications, and supplements. They may ask about things like:
• Meal timing and portion sizes
• Your typical diet and nutrition
• Caffeine and alcohol intake
• Stress levels
• Sleep position
• Weight changes
This information helps them determine whether your reflux is related to lifestyle/diet factors, underlying conditions, or both.
Sometimes, a gastroenterologist may recommend further diagnostic tests. Not everyone needs this, but it is often suggested if reflux symptoms are persistent, complex, or unclear. Having one of these is quite common for those with chronic or severe acid reflux.
Upper endoscopy
In an upper endoscopy procedure, a thin tube with a camera is used to view the esophagus and stomach. This helps the specialist detect inflammation, damage, or structural issues that may be caused by or contributing to acid reflux.
Esophageal pH monitoring
Esophageal pH monitoring is a test that measures how often acid enters the esophagus over a 24-hour period.
Esophageal manometry
In an esophageal manometry test, the esophagus is evaluated for how well it moves food downward. The lower esophageal sphincter is also examined for functionality.
Imaging tests
While it's more uncommon, occasionally an ultrasound or X-ray may be used to rule out other causes of discomfort, in addition to one or more of the previously listed tests.
Some of these tests, like the upper endoscopy, are popular. While it is easy to be concerned, these tests are very safe. Your gastroenterologist will explain why each test is or is not necessary based on reflux symptoms or specific details. Find out more about these tests here.
Once the gastroenterologist understands your reflux symptoms and what you are experiencing, they will often recommend an initial treatment plan tailored to your needs. These plans often include:
Diet adjustments
Having a reflux-friendly diet can improve symptoms. This usually consists of low acid meals, avoiding trigger foods, smaller portions, and reduction of high fat foods.
Lifestyle changes
Similarly to diet adjustments, lifestyle changes can help relieve reflux. Lifestyle changes typically focus on things like meal times, sleep position, evening routine, and light exercise.
Medications
For severe or chronic acid reflux, or if a person is diagnosed with GERD, the gastroenterologist may suggest or prescribe PPIs, H2 blockers, alginate-based products, or antacids. These are commonly taken to relieve either short-term or long-term symptoms.
Medication adjustments
If you are already on a medication, such as a long-term PPI, the specialist may help you find an optimal dose or plan a tapering schedule if appropriate.
Strategies for stress management
Since stress can increase reflux symptoms, the gasteroenterologist may suggest specific techniques to help reduce stress.
The initial treatment plan is often further revised or personalized later on. Reflux and GERD often requires adjustments over time, so follow-up visits are often required and help track one's progress.
Typical questions people ask include:
• What is the likely cause of my reflux?
• Do I need testing right now?
• Which foods should I avoid?
• Are long-term medications like PPIs right for me?
• How can I reduce reflux symptoms at night?
• How soon should I expect improvement?
These questions can help you understand your diagnosis and feel more confident in your care plan.
