GASTROESOPHAGEAL REFLUX

INDICATIONS:

1. Detection and quantitation of gastro-esophageal reflux
2. Suspected aspiration pneumonia.

PATIENT PREPARATION:

1. NPO past midnight or at least 4 hours prior to study.
2. Nasogastric tube for pediatric patients.

RADIOPHARMACEUTICAL:

1 mCi Tc-99m albumin or sulfur colloid in acidified orange juice (150 mL of orange juice plus 150 mL 0.1 N hydrochloric acid) is given orally. In children the radiopharmaceutical dose is reduced and given with formula via NG tube.

SCANNING TIME:

1. An abdominal binder or valsalva maneuver (only in adults) is used to increase intra-abdominal pressure and supine images of the stomach and esophagus are acquired. This imaging requires 40-60 minutes to complete.
2. For evaluation of possible aspiration: Delayed views are performed at 4 and possible 24 hours. These images take 20-30 minutes to acquire.

OTHER CONSIDERATIONS:

The acid, abdominal binder, and supine positioning are used to promote reflux. Sensitivity with this method is in excess of 90%. Computer analysis quantitates the total percent of reflux and the number of times reflux occurred during the hour after the administration of the radiopharmaceutical.