Gastroesophageal reflux: how much imaging is required?

The authors present a protocol for the selection of imaging studies for infants suspected of gastroesophageal reflux. In most cases, only a single imaging procedure is required. Three groups of patients are considered: those suspected of an esophageal or postgastric obstruction who require a barium GI series; those who appear to have reflux and a possible gastric obstruction in whom sonographic study of the gastric outlet is advised; and those suspected of aspirating in whom the possibility of reflux is studied by scintigraphy. Esophagoscopy and other studies are reserved for those refractory to therapy.