Ultrasonographic Criteria Aiding in Noninvasive Diagnosis of Gastroesophageal Reflux Disease

Background: Gastroesophageal reflux disease (GERD) is a common disorder that often requires endoscopic evaluation.Cervical ultrasonography has emerged as a potential tool for assessing esophageal structural changes associated with GERD, particularly those related to wall thickness and luminal diameter. This study aimed to evaluate the diagnostic utility of cervical esophageal ultrasonography in patients with GERD, focusing on the effect of non-erosive reflux disease (NERD) on esophageal diameter and the effect of erosive reflux disease (ERD) on wall thickness. Methods: A cross-sectional study was conducted on 60 adults diagnosed with GERD by upper endoscopy who underwent cervical esophageal ultrasound using a linear 7.5-MHz probe. Measurements of luminal diameter and wall thickness were taken in the axial plane during quiet respiration. Endoscopic findings were used to classify patients into NERD and ERD groups. Results: Increased cervical esophageal wall thickness (≥2.8 mm) was significantly associated with erosive reflux disease, being present in 55% of patients with esophagitis compared with 5% of those without (p = 0.01), and showed a significant positive correlation with esophagitis severity (r = 0.49, p = 0.001). Receiver operating characteristic (ROC) curve analysis demonstrated good diagnostic performance of cervical esophageal wall thickness for identifying non-erosive reflux disease, with an optimal cutoff of ≥2.63 mm (AUC = 0.719), yielding 70% sensitivity and 80% specificity. Conclusion: The method of transcutaneous transabdominal ultrasound examination of the GERD is non- invasive, reasonable and practically no contraindications diagnostic method which can be carried out in outpatient and inpatient institutions to verify the diagnosis of GERD.