24-h pH monitoring and esophageal manometry are the gold standards of methods used for diagnosing GER and esophageal motor disorders, respectively. Intraluminal refluxate can be recognized by US images. Sonographic GER diagnosis is made by backward movement of gastric content into the esophagus and the visualization of the clearance of refluxate material. Postprandial refluxate was seen in 45 of 500 (9%) adults. GER and/or manometric pathology was found in 71.1% of the refluxate positive patients.
This research fingding, published sometime in October 21 issue of World Journal of Gastroenterology, describes the relationship of cervical esophagus ultrasound with ambulatory 24-h pH-monitoring and esophageal manometry.
The head researcher, S. Kacar, planned the study the facts that 1) it is possible to visualize GER episodes and estimate GERD in the GEJ region in US infants and children; and 2) esophageal motor disorders can cause abnormal fluid or viscous bolus transit in the lumen of the esophagus. The aims of the study were to compare the TCEUS findings in the patient subgroups divided according to 24-hour esophageal pH monitoring and manometry, and to investigate the possible cut-off values according to the TCEUS findings as a predictor of GER and/or esophageal dysmotility.
This study is the first to show refluxate presence in the cervical esophageal lumen along with TCEUS parameters measured transcutaneously, while also correlating pH monitoring and esophageal manometry findings, in adults.
Esophageal US is a non-invasive, readily available, repeatable, cheap and fast technique. In conclusion, Kacar notes that TCEUS can not substitute for 24-h pH monitoring or esophageal manometry, although it can serve as a complementary technique by aiding in the estimation of GER and motility disorders, which can cause impairment of bolus transit in adults.
Reference: World J Gastroenterol 2007 October 21; 13(39): 5245-5252 http://www.wjgnet.com/1007-9327/13/5245.pdf
Correspondence to: Sedef Kuran, MD, Gastroenterology Department, Turkiye Yuksek Ihtisas Hospital, Dikmen Cad. 220/A, No. 17 Dikmen, Ankara, Turkey. sedefozdal@hotmail.com Telephone: +90-505-2774366 Fax: +90-312-3124120
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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