Figure 2 from Diseases of the esophagus: diagnosis with esophagography. | Semantic Scholar (2024)

The diagnosis of gastroesophageal reflux disease should be made by barium studies, but discrete inflammation as well as epithelial dysplasia are best investigated by classic endoscopy and modern endoscopic techniques.

In patients with GERD, a barium swallow describes the anatomy of the esophagus and stomach and an upper endoscopy determines if mucosal injury is present and excludes gastric and duodenal pathology.

Though use of barium esophagography/barium swallow has decreased in day to day clinical practice, it still remains a valuable test for structural and functional evaluation of esophagus.

The role of radiological studies for correct assessment of structural and functional pathologies at the level of the lower esophageal sphincter is reviewed.

The most frequent conditions associated with esophageal strictures on esophagogram are reviewed and can be used to distinguish between malignant and non-malignant conditions.

Esophagography was useful for the evaluation of morphology and caliber of the esophagogastric channel, while ETS was usefulfor the functional evaluation of esophageal emptying.

Significant improvements in both the ring lumen diameter and the ability to pass a tablet through the esophagus indicate that acid suppression medication is an effective alternative to the use of dilation procedures for the treatment of Schatzki rings.

According to the last guidelines on GERD, these techniques are not recommended in the routine diagnosis of GER/GERD, but they can exclude other disorders which can simulate GERD.

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The major value of double-contrast esophagography is its ability to separate patients into high, moderate, and low-risk groups for Barrett's esophagus to determine the relative need for endoscopy and biopsy.

It is suggested that double-contrast barium studies and endoscopy have limited ability to detect reflux esophagitis, in particular mild esophageal cancer, when using the histologic findings as the gold standard, and when radiographic abnormalities are detected, mucosal granularity is the single best sign of reflux Esophagus on double-Contrast studies.

The double-contrast barium study is a sensitive technique for the diagnosis of carcinoma of the esophagus and esophagogastric junction and can be achieved while recommending endoscopy in only about 1% of all patients who undergo barium studies.

The double-contrast examination technique showed an advantage over single- Contrast radiography only if a granular pattern and erosions were the only radiographically detectible features of esophagitis.

The medical treatment to be directed toward reduction the reflux, acid inhibition and accelerated clearance of acid, and the elevation of the head of the bed and the change of lifestyle can pay large dividends in the treatment and must to maintain all the life.

Since there appears to be no specific sign of Barrett esophagus, a multifaceted approach is suggested concentrating on the association of Barrett Esophagus with the radiographic signs of severe reflux esophagitis.

In seven cases, double-contrast radiography also revealed a delicate reticular pattern in the esophagus that appears to be a specific radiologic criterion for the diagnosis of Barrett esophageal reflux.

It is indicated that a radiologically granular or nodular appearance of the esophageal mucosa often indicates reflux esophagitis and less commonly identifies diffuse lesions of variable origin.

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