What is the best way to diagnose GERD?

The Buzz: A simple point-of-care tool can help with the diagnosis of GERD
Citation: "Diagnosis of Gastroesophageal Reflux Disease" AFP  2010 May 15;81(10):1278-1280.
Summary: Upper abdominal symptoms are common in primary care, and this article presents two clinically-validated point-of-care tools for the diagnosis of GERD. The first, called "GerdQ", is a 5-item survey which predicts the likelihood of the diagnosis of GERD. This can be given to the patient at registration and was shown to be comparable to diagnosis by a specialist. The second is a clinical scoring guide which uses BMI and a few other data points to predict response to omeprazole. While calculating the score is slightly more time-consuming, the authors point out that in patients of average or increased weight, nighttime pain or recent antacid use predicts a good response to omeprazole*, a rule which provides an even more efficient way to decide if its use is worth recommending.
Commentary: Any shortcuts to the diagnosis and management of this common condition are welcome. *See recent post on PPIs.
By: Spencer Blackman MD