Gastro-oesophageal reflux demonstrated by radiography

Abstract

Purpose: Gastro-oesophageal reflux (GOR) is demonstrated by radiography as a supplement to 24-h pH monitoring.

Material and Methods: Forty-two patients (mean age 44 years) with suspicion of GOR disease were assessed according to a standard questionnaire. GOR was investigated by 24-h pH-monitoring and by radiography. Oesophageal emptying and the presence of rings or strictures were registered as well. Mucosal biopsies, classified as normal, light oesophagitis, severe oesophagitis, or Barrett's oesophagus, were correlated to age, gender, symptomatology, pH monitoring, and oesophageal emptying. GOR and morphological changes demonstrated by radiography were correlated to pH monitoring and mucosa biopsies.

Results: Based on pH monitoring, patients with severe oesophagitis and Barrett's oesophagus had a significantly higher acid exposure compared to patients with normal mucosa and light oesophagitis, with no difference concerning age, gender, and symptoms. Severe oesophagitis, including Barrett's oesophagus, was found only in patients with a positive test for radiologic GOR. Eleven patients had rings or strictures independent of oesophageal mucosal changes.

Conclusion: GOR demonstrated by radiography identified patients where complications could be expected, which was not possible by pH monitoring alone.