Timed barium swallow for assessing long‐term treatment response in patients with achalasia: Absolute cutoff versus percent change – A cross‐sectional analytic study

Abstract

The timed barium swallow (TBS) was initially described by de Oliveira and colleagues at the Cleveland Clinic in 1997. 1 TBS is a simple test with low radiation exposure and low cost designed to assess esophageal emptying in patients with achalasia before and after treatment. 1 In this technique, the patient is asked to drink 100-200 ml of low-density (45% weight in volume) barium sulfate over one minute in the upright position followed by frontal spot films of the esophagus obtained at one, two, and five minutes. 1 The degree of esophageal emptying may be assessed qualitatively by comparing one minute and five minutes films or by measuring

Therapieoptionen von primären Motilitätsstörungen des Ösophagus

“…Neben der präoperativen endoskopischen Diagnostik, welche essenziell ist zum Ausschluss eines Malignoms des oberen Gastrointestinaltrakts im Sinne einer Pseudoachalasie [61,62,63] Die radiologische, dynamische Darstellung der Peristaltik des Ösophaguskorpus kann gelegentlich Aufschluss über einen Etagenspasmus auch im Ösophaguskorpus erbringen. Hier ist präoperativ ein "Timed Barium Swallow" (TBS) sehr hilfreich, insbesondere bei multiplen Vorbehandlungen zur Evaluation des vorherigen Therapie-Ansprechens [66,67]. Dabei ist die Änderung des Barium-Oberflächenspiegels eine überlegenere Messmethode der ösophagealen Entleerung und korreliert besser mit dem Ansprechen auf die Therapie verglichen mit der "konventionellen" Evaluation der "5-Minuten-Bariumsäule" für die Definition der objektiven Response nach Achalasie-Behandlung.…”

Esophageal Motility Disorders: Current Approach to Diagnostics and Therapeutics

“…44 TBE can also help with postachalasia treatment monitoring because a 3% improvement from pre-to posttreatment barium height at 5 minutes rather than absolute cutoff value of <5 cm on post-treatment TBE might be a better indicator of long-term clinical remission. 45…”

A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans

“…In patients with cricopharyngeus muscle dysfunction, smaller volumes or thicker consistencies can minimize aspiration and improve swallow safety although larger volume, thinner consistencies can reveal abnormalities and improve diagnostic yield (178,180,210,211). For dogs with esophageal achalasia, timed barium esophagrams can be performed in which barium retention is assessed at specified time intervals following ingestion (214,215). For patients with suspected hiatal herniation or GERD, provocative maneuvers akin to those used in humans could be performed to improve detection (83).…”