A businessman who presented with substernal heaburn is diagnosed having gastroesophageal reflux disease (GERD). BEST test to diagnose GERD and quantify acid output is:
The most sensitive test for diagnosis of GERD is 24-h ambulatory pH monitoring. Endoscopy is indicated in patients with reflux symptoms refractory to antisecretory therapy; in those with alarming symptoms such as dysphagia, weight loss, or gastrointestinal bleeding; and in those with recurrent dyspepsia after treatment that is not clearly due to reflux on clinical grounds alone. Ref: Wong-Kee-Song L.M., Topazian M. (2012). Chapter 291. Gastrointestinal Endoscopy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Esophagogram
Endoscopy
Manometry
24 hour pH monitoring