CT scans of the chest and abdomen can be very helpful in identifying and measuring the size and location of a hiatal hernia, but they are not very helpful in determining the presence or extent of reflux disease. CT and MRI scans are not generally part of the work-up for GERD, but they may be helpful in looking for other conditions.
Barium Swallow and Upper GI X-rays are commonly used to evaluate the esophagus and stomach. Barium is a thick liquid that provides a traditional contrast material that allows the esophagus, stomach and small intestine to be visualized using conventional x-ray. While these tests can provide helpful information about the anatomy, including the size and nature of a hiatal hernia or stricture in the esophagus, these imaging studies offer little useful information about the function of these organs. The notable exception is the assessment of how well the stomach empties. For patients with diabetes, poor gastric emptying can play an important role in producing GERD like symptoms.