Comparison of diagnostic value of video barium esophagography (VBE) and double channel 24 hour esophageal pH monitoring in gastroesophageal reflux disease (GERD) associated with respiratory complications

Aim: to investigate the diagnostic value of VBE and 2ch 24h pH monitoring in GERD patients (pts) with respiratory complications.

Methods: 30 pts (M/F 9/21) with GERD associated airway diseases were submitted to upper gastrointestinal endoscopy, 2ch 24h esophageal pH metry and barium swallowing test.

Results: The endoscopy revealed non-erosive esophagitis 16 pts, erosive form in 14 pts, respectively. 24h pH monitoring 5cm above the LES demonstrated an abnormal DeMeester score only in 10 pts. Postprandial or diurnal reflux episodes were seen in 17 and 11 pts, respectively. The distal pH monitoring was normal in 2 pts without pathological reflux events. Proximal pH monitoring showed postprandial, diurnal and nocturnal reflux events in 14, 5 pts and 1 pt, respectively. 10 pts had normal proximal pH values. VBE revealed gestroesophageal reflux in 24 cases. The extent of reflux reached to the lower third in 5 cases, the middle third in 3 cases and up to the pharyngeal portion in 16 pts. VBE and pH metry of the distal esophagus appeared identical in 24 pts. 5 pts had normal VBE study, and abnormal pH monitoring, and 1 pt had normal pH curve, but abnormal VBE. Regarding the proximal esophagus VBE and pH metry showed identical data in 19 pts. 7 pts had normal VBE study, while pH monitoring revealed pathological proximal reflux events. In 4 pts, in spite of normal pH metry, VBE demonstrated proximal reflux.

Conclusion: This study demonstrated, that VBE is less sensitive than the double channel 24h pH monitoring, but able to provide valuable complementary data in pts with suspected supra-esophageal GERD complications.