Gastroesophageal reflux disease occurs when stomach acid backs up into the esophagus (tube connecting the stomach and mouth). This can irritate the lining of the esophagus, cause narrowing of the esophagus and eventually lead to cancer in some. Barium swallow tests are sometimes done to evaluate GERD symptoms and it’s complications.
What is GERD?
Gastroesophageal disease (GERD) is when stomach acid backs up into the esophagus.
Symptoms of GERD
This common condition can produce symptoms such as burning sensations in the stomach area, chest, dry cough, swallowing difficulties and other symptoms.
Why is barium swallow done for GERD?
Your doctor will order a barium swallow to further look for the reason behind your symptoms and to identify any complications of GERD.
What is a barium swallow test?
A barium swallow or esophagram is a test that evaluates the structure and function of the esophagus. This test is done by a radiology doctor who evaluates the esophagus using X-ray after the patient swallows barium contrast.
Can a barium swallow detect GERD?
Yes it can. We can see the swallowed barium back up into the esophagus from the stomach.
Can barium swallow miss GERD?
Not seeing reflux or backup of barium into the esophagus does not exclude GERD on a barium swallow test.
How is GERD diagnosis confirmed?
pH acid probe test monitors when and for how long stomach acid refluxes into the esophagus.
Upper endoscopy is when a thin flexible tube with a light and camera is used to examine the esophagus for any damage or complications of GERD.
What are the findings of GERD on a barium swallow?
Minor cases may produce no visible abnormalities on barium swallows despite patients having symptoms.
In more advanced cases, abnormalities are often seen. Most commonly, there is reflux of the swallowed barium into the esophagus either spontaneously or when the patient bears down. Not seeing reflux does not exclude it.
There is abnormal esophageal motility and clearance. You can see abnormal function and delayed passage of barium contrast through the esophagus.
Some patients may have findings of an inflamed esophagus.
Patients can have abnormal areas of narrowing and scarring.
Hiatal hernias occur where the stomach protrudes into the chest through the opening of the esophagus. These hernias are often associated with reflux. They are commonly seen on barium swallows.
Is GERD dangerous and can it cause cancer?
One of the more important abnormalities associated with reflux disease is Barrett esophagus. This is a precursor to cancer of the esophagus. Unfortunately, this is usually not seen on esophagram and is therefore not adequate for screening. This is a finding that is seen on endoscopy and biopsy done by a gastroenterologist.
Cancer is a complication that can occur following GERD. Unfortunately, early cancer of the esophagus is frequently not identified on an esophagram. Endoscopy is needed for more complete evaluation.
Treatment of GERD
Treatment is medical for more minor cases of gastroesophageal reflux.
A fundoplication is a surgery done for more advanced cases where a fold of the stomach is wrapped around the lower part of the esophagus near the stomach.
What kind of doctor can treat GERD?
Many cases of GERD are treated by primary care providers. More severe cases are managed by gastroenterologists and surgeons when surgical therapy is being considered.
Barium swallow test for GERD: summary
GERD is the backup of stomach acid into the esophagus. Barium swallow tests can diagnose GERD and its complications. More complete testing and diagnosis can be done with pH probe monitoring and endoscopy. GERD can cause both troublesome symptoms and lead to dangerous complications like cancer. Early diagnosis and treatment is therefore important.