Introduction to the special section on gastroesophageal reflux disease: radiologic, clinical, and surgical perspectives
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We are honored to serve as co-guest editors for a special focus section in Abdominal Radiology on radiologic imaging of gastroesophageal reflux disease (GERD). This section represents the collaborative work of many of the members of the Society of Abdominal Radiology’s Disease-Focused Panel on GERD and other leading experts in the field. The goal of this section is to provide a state-of-the-art symposium on the role of gastrointestinal (GI) fluoroscopic studies in the diagnosis of GERD and its complications.
GERD is one of the most common diseases affecting the GI tract, with a prevalence of 10–20% in the Western world. Despite the widespread use of endoscopy in modern medical practice, the esophagram remains a widely available, safe, and inexpensive test for detection of GERD and its complications.
The articles in this focus section provide radiologic, clinical, and surgical perspectives on the value of GI fluoroscopic studies for patients with known or suspected GERD. In the first article, Levine and Carucci review the techniques for performing high-quality esophagrams in patients with symptoms of GERD and discuss the radiographic findings associated with various manifestations of GERD, including reflux esophagitis, peptic strictures, and Barrett’s esophagus.
In the second article, Rubesin and Levine discuss the extraesophageal manifestations of GERD, particularly those involving the pharynx. As the authors make clear, a wide spectrum of structural and functional abnormalities of the pharynx can be diagnosed on barium swallows in patients with underlying GERD.
In the third article, Disantis discusses recent trends in the utilization of esophagography for evaluation of GERD. Although all types of GI fluoroscopic studies have declined in volume over the past several decades, the volume of esophagrams performed in the United States has remained relatively stable in recent years. This article also discusses how the barium study continues to be a useful diagnostic test for GERD, unlike other luminal GI diseases that increasingly have been evaluated by other more expensive cross-sectional imaging studies such as CT and MR.
In the fourth article, Zarzour et al. describe various anti-reflux procedures performed for treatment of intractable GERD and review the complications and imaging findings associated with these procedures. In the final two articles, a gastroenterologist and surgeon with particular expertise in GERD offer a clinician’s and surgeon’s perspective on the role of barium studies in patients with this disease.
We believe this special focus section offers the reader a comprehensive review of the role and utility of barium studies for patients with GERD and its complications, particularly emphasizing what is most clinically relevant for gastroenterologists and GI surgeons who treat these patients. We thank all of our contributing authors who donated their time and expertise to this collaboration.