Consistent postprandial regurgitation in young dogs also can be caused by various other congenital and acquired abnormalities that must be differentiated from PRAA.  Most common are foreign bodies and megaesophagus but others include an overly long esophagus, esophageal stricture, and horizontal heart.

Often, a simple DV or VD survey radiograph provides a reliable diagnostic sign of PRAA: moderate to marked leftward curvature of the trachea near the cranial border of the heart was found in 27/27 dogs with PRAA and in none of 63 control dogs or 30 dogs with megaesophagus.  Barium esophagrams sometimes obscure this sign.