Transcutaneous cervical esophageal ultrasound can not substitute for 24-h pH monitoring or manometry

Oct 10 2007

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.