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Barium X-ray examinations are useful tools for the study of appearance and function of the parts of the gastrointestinal tract. They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varices, ulcers, tumors, and gastrointestinal dysmotility, as well as to detect foreign bodies.
Once this has been completed, the endoscope is withdrawn into the stomach and a more thorough examination is performed including a J-maneuver. This involves retroflexing the tip of the scope so it resembles a 'J' shape in order to examine the fundus and gastroesophageal junction. Any additional procedures are performed at this stage.
In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.
FLIP may be used as a complementary test for barium esophagram for evaluating esophageal outflow obstructive disorders. FLIP may be used to assess the effect of treatment for achalasia. [citation needed] FLIP is recommended to further evaluate suspected esophagogastric junction outflow obstruction (EGJOO) where the manometry is normal or ...
An EMS is typically done to evaluate suspected disorders of motility or peristalsis of the esophagus.These include achalasia, diffuse esophageal spasm, nutcracker esophagus and hypertensive lower esophageal sphincter.
Transnasal esophagoscopy is an office based procedure in which the patient is anesthetized locally in the nose and sometimes the oropharynx.The scope is advanced into the ipsilateral pyriform sinus and through the esophageal inlet to the stomach, where the esophagus can be examined, with special attention paid to the gastroesophageal (GE) junction. [10]
The diagnosis of esophageal perforation could also be confirmed by water-soluble contrast esophagram (Gastrografin), which reveals the location and extent of extravasation of contrast material. Although barium is superior in demonstrating small perforations, the spillage of barium sulfate into the mediastinal and pleural cavities can cause an ...
Imaging usually confirms the diagnosis because a barium esophagram can show the location, size, and lateralization of the lesion. Although there are other modalities such as esophageal endoscopy, CT scan, and ultrasound, most clinicians rely on barium esophagram to make clinical decisions.