Gastroscopic and transabdominal ultrasonographic evaluation of the gastroesophageal junction in patients with gastroesophageal reflux disease

Abstract

Background Gastroesophageal reflux disease (GERD) is a common disease in the population. GERD is classified into two categories: nonerosive reflux disease (NERD) and erosive reflux disease (ERD). The aim of this study is to investigate the value of non-invasive, cost effective and more easily applicable transabdominal ultrasonography (US) in the evaluation of GERD disease. Methods The study was designed as a single-centre, cross-sectional, prospective, single-blind study. The thickness of the esophagus wall and fat, as well as the diameters of the hiatus and gastroesophageal junction (GEJ), were measured using US. Results The study had 99 patients, including 47 females and 52 males. Patients exhibiting esophagitis and reflux symptoms showed a significant increase in esophageal wall thickness, hiatus diameter, GEJ diameter and esophageal fat thickness, as indicated by US, compared to the control group. p < 0.001, p < 0.001, p < 0.001, p = 0.001 for esophagitis and GERD; p < 0.001, p < 0.001, p < 0.001, p = 0.004, respectively. ROC curve analysis revealed the accuracy rates for esophagitis were 67.9%, 70.5%, 73.1% and 69.2%, respectively. Individuals with GERD exhibited accuracy rates of 63.7%, 69.7%, 67.9% and 62.7%, respectively. The binary forward logistic regression analysis of both groups revealed that only the GEJ diameters exhibited a high level of significant (p < 0.0001) in predicting outcomes. Conclusion This study found a sonographically visible difference in esophageal wall thickness, hiatus diameters, GEJ diameters and paraesophageal fat thickness between patients with and without GERD, particularly GEJ diameters were statistically significant to predict GERD. These data suggested that US could be used as a screening method before endoscopy in selective patients.