SCREENING OF GASTROESOPHAGEAL REFLUX DISEASE BASED ON THE SIZE OF THE GASTRIC GAS BUBBLE

Abstract

Objective: to determine the possibility of screening for gastroesophageal reflux disease (GERD) by size and shape of the stomach gas bubble on the direct X-ray of the chest and abdomen. Methods and results. One hundred seventy-five radiographs of patients of different ages were analyzed by the random sampling method. The shape of the stomach gas bubble (SGB) was determined and its width and height were measured. Results. SGB was detected in all pediatric patients. It was absent in 18% of adults (16-64 years) and in 25% of the patients aged 65 years and older. In majority of patients fundus had a shape of a dome with the level of liquid content. In 6% of patients the SBG was deformed with an angular protrusion in the shape of the «bird beak» pointing in the direction of the spine. The more advanced was the age of a patient the more increase in volume of SBG we observed in the sagittal plane. In the direct projection, age had no significant influence on the average size of the SGB (except without SGB). There was a significant increase in the width of GBS in older children (7-15 years) compared to children aged 1-6 years. In adults, there was a tendency to have smaller width and height of SBG (P> 0.1). In elderly, we found a significant decrease in these parameters. Discussion. The size of the dome of SGB, which is a «trap» for the air, depends on the stability of its walls. In GERD the intraperitoneal portion of the lower esophageal sphincter is weakened and is opened either temporarily under the pressure, or permanently. In such cases, the dome is deformed with the formation of a corner protrusions, and reduced in size. Conclussion. The absence of GBS, or the decrease of its size, or the angular protrusion of its inner wall on the x-ray suggest the possibility of GERD. Further research is needed to determine the normal width and height of GBS.