Review symptoms and triggers
Check for heartburn
Check for acid regurgitation
Assess chest discomfort
Assess sore throat or hoarseness
Assess chronic cough
Assess trouble swallowing
Review symptom timing after meals or when lying down
Review response to antacid or acid-suppressing medicine
Perform a physical examination
Consider a trial of treatment with a proton pump inhibitor
Perform upper endoscopy if symptoms are severe, persistent, or concerning
Perform ambulatory pH monitoring
Perform esophageal impedance testing
Perform esophageal manometry if needed
Evaluate for alarm signs
Rule out other causes of symptoms
Consult a gastroenterologist if diagnosis is unclear