Gastroesophageal Reflux

  • Etiology: laxity of the gastroesophageal sphincter
  • UGI: before beginning exam pull any nasogastric tube present up into the esophagus as a nasogastric tube can stent open the gastroesophageal junction and induce gastroesophageal reflux, contrast refluxing from stomach into esophagus, must describe how high reflux extends up into esophagus, determine whether patient has gastric outlet obstruction, realize the UGI study is only assessing for reflux for a few minutes out of a 24 hour day
  • DDX: gastric outlet obstruction
  • Complications: aspiration pneumonia
  • Treatment: positioning during feeding, medicine, Nissen fundoplication
  • Clinical: present with vomiting with feeds or recurrent pneumonia, gold standard for diagnosis is 24 hour pH probe

Cases of Gastroesophageal Reflux

CXR of pH probe
CXR AP shows a catheter with markers on it projecting within the esophagus which represents a pH probe whose sensor port, which appears as a minus (-) sign, is in appropriate position 3-5 cm above the gastroesophageal junction