title: Barium studies for detecting esophagopharyngeal reflux events.
abstract: Esophagopharyngeal reflux (EPR) is among the factors involved in the supraesophageal complications of reflux disease, and is diagnosed by the regurgitation of barium from the upper third of the esophagus into the pharynx in the absence of swallow during a videofluoroscopic swallowing study. EPR is detected in approximately 20% of patients undergoing these studies, and occurs in different clinical groups without disease-specific associations. The vast majority of patients with EPR show esophageal motor abnormalities on swallowing studies. Notably, prolonged esophageal clearing time is independently and strongly associated with EPR. Our data suggest that the oropharyngeal phase of deglutition is impaired in >50% of patients with both gastroesophageal reflux disease and EPR. In the subset of patients with EPR, oral abnormalities are mostly related to tongue function. Based on the data emerging from our videofluoroscopic swallowing studies, it seems plausible that EPR occurs as a result of an underlying esophageal motor dysfunction facilitated by an impaired oral deglutition. As a consequence, when examining patients for EPR, both esophageal and oropharyngeal abnormalities should be sought.
authors.affiliation: Department of Clinical Science, Università La Sapienza, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Torrico
authors.forename: Enrico
authors.initials: E
authors.lastname: Corazziari
authors.forename: Fortunée Irene
authors.initials: FI
authors.lastname: Habib
mesh_terms: D001466:Barium Sulfate; D003287:Contrast Media; D015154:Esophageal Motility Disorders / Q000175:diagnosis; D005471:Fluoroscopy; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D010614:Pharynx / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015995:Prevalence; D014741:Video Recording
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate