Source: Diabetologia  |  Posted 9 years ago

Traditional radiography allows for correct anatomical interpretation of gastroesophageal reflux disease (GERD), according to investigators in Italy.

To examine 1,388 patients with GERD, researchers from the Policlinico Sant'Orsola-Malpighi, in Bologna, used traditional radiograms taken after administration of a small high-density bolus of barium.

Radiograms were obtained with patients in various positions: in frontal position, at rest, during forced inspiration, and during straining; standing in a right front 30 degrees oblique position; and in prone position with a right posterior 30 degrees oblique projection.

The researchers identified five groups of patients with pathologically characteristic signs based on their radiological findings, and in agreement with the radiological classifications previously reported in other studies. These were: (1) 16% with an esophago-gastric junction regularly placed in the abdomen when standing and 47% with a regularly-placed esophago-gastric junction and a small sliding intermittent hiatus hernia; (2) 13% with cardial tuberosity malposition; (3) 7% with concentric hiatus hernia; (4) 8% with acquired short esophagus; (5) 9% with massive incarcerated gastric hiatus hernia.

Traditional radiography allows correct anatomical interpretation of GERD, and should be the first approach used to determine the treatment of patients with GERD, the investigators conclude.