HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Is An Esophagram The Same Thing As An Upper G.I Endoscopy Is Called Esophagoscopy (esophagus) ?

Posted on Wed, 23 Nov 2022

Question: Hello. Recently I requested an Upper GI Series test for chronic right upper quadrant pain.
So I took what I thought, and was told in writing, was an Upper GI Series test. However, when you look at the attached report, you can see that it says it's an 'Esophagram'. Furthermore, it only comments on the very top parts of the stomach(fundus and gastric cardia), not the areas where I'm having pain. Is an Esophagram the same thing as an Upper GI Series test? If not, then they ran the wrong test, didn't they?
If so, do you know why it didn't make any mention of the appearence of the lower part of the stomach and duodenum?

Thanks,
XXXXXXX Pierce

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
He should have done complete endoscopy

Detailed Answer:
Hello,
Thanks for query,
Upper G.I endoscopy is called esophagoscopy if camera remains till esophagus only.
Basically if the endoscope is passed to esophagus its esophagoscopy while if its passed to stomach its called endoscopy.
Right sided pain is usually due to acid reflux therefore esophagoscopy has been done.
Its not understandable that why stomach is neglected because GERD involves gut as well as esophagus.
The best answer is ask you gastro why he neglected stomach etc and then message the reply back to me.

Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Ramesh Kumar (33 hours later)

Hi. Just to be clear, this was NOT an endoscopic procedure. It's the kind of test where they make you swallow Barium and then take xrays of you from outside your body. Does that change your opinion about the situation?

Thanks

Answered by Dr. Ramesh Kumar (17 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello again,
Thanks for follow up,
Basically Barium swallow is meant to see any blockages in upper gastro intestinal tract.
However going through your problem and site of pain two basic tests to be done are-
Ultrasound of upper abdomen(to rule out bladder problem).
Endoscopy of gut.
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (34 minutes later)

Thanks, but my question still stands: does an Esophagram(see attached) even examine the GI tract beyond the upper part of the stomach? Another way of asking: is it different from an Upper GI Series, which DOES examine the whole upper gi tract including the duodenum? As you'll notice if you look at the attached test result, the procedure they ran was an Esophagram, and makes no comment on the appearance of the stomach beyond the gastric cardia. The test I had requested was an Upper GI Series. I'm trying to find out if they ran the wrong test.

Thank you for your careful answer,

Answered by Dr. Ramesh Kumar (27 minutes later)

Brief Answer:
Follow up suggestions.

Detailed Answer:
Hello again,
No my dear patient a barium swallow can find anomaly till esophagus only.
Its just a part of Upper G.I series and not a complete upper G.I test in itself.
They are suspecting you as a patient of GERD(which means gastro esophageal reflux).As the name suggest they should have done endoscopy as acid is refluxed into esophagus from stomach only.
Regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (32 hours later)

Thank you Doctor. I heard back from the doctor who ordered the test. He said he asked the radiologist that performed it why he did an esophagram instead of the full upper gi series. He said it was for the following reasons:
- he could see with the naked eye there was no pathology there
- he did a comparison with a recent abdominal MRI I had. There was no pathology found in the stomach or duodenum on that test either.

So, he said he decided to cut the test short, in order to spare me more radiation.

But I was always told that an MRI CANNOT examine the gi tract(stomach, duodenum and intestines). Can an abdominal MRI examine these areas?

By the way, my MRI test results say nothing about my stomach or duodenum.

Thanks again,

Answered by Dr. Ramesh Kumar (4 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hi,

No MRI can't be used to rule out conditions like GERD.
Endoscopy should be done.

Thanks

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (7 hours later)

Hello, and thanks again.

Is is typical for a radiologist to decide to cut a test short(ie. not do the complete study of the images in the lab), because he saw nothing alarming with the naked eye when viewing the xrays while the test was running?

That's what they told me was the reason I only got an esophagram, not the full upper gi series. But that sounds a little strange to me. I would think they would do the complete study, just to be absolutely sure they did not miss anything.

Thanks.

Answered by Dr. Ramesh Kumar (7 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:

Hello again,
Firstly Xray has no significance in determining GERD or acid peptic disorders.
It can only rule out mass or blockage in gut.
He should have done a complete study.
These are all lame explainations he is giving to convince you using medical words.
Regards!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (35 hours later)

Thank you very much, Doctor. That's what I suspected.
However, today they sent me an 'addendum' about the test,
in response to my concerns. Could you please look at the
uploaded file 'VA Fluoroscopy Test Results with Addendum'
and let me know if it changes your opinion at all?

Thanks once again.

Answered by Dr. Ramesh Kumar (13 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello again dear patient,
As per the impression-
"You have gastroesophageal reflux. You should consider restarting a
medicine like omeprazole or pantoprazole."

Most important cause of GERD is Hiatel hernia.Without examining your stomach and duodenum how come they are sure that your GERD is not due to Hiatel hernia or ulcers in stomach or A lax sphincter.
Role of doctor is to find out the cause omeprazole can be given to you even by pharmacy person.
Just forward this to them for explaination.

Lastly omeprazole is an acid inhibitor but as per diagnosis you are having acid reflux so treatment is partial he should add prokinetic to prevent reflux of acid in esophagus.
Regards!

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Kampana