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Updated: Jun 18, 2026

Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation
Published on: September 22, 2023
Form of gastric air bubble is associated with gastroesophageal reflux symptoms
Toshiyasu Watanabe1, Yoshihisa Urita, Tadashi Maeda
1Department of General Medicine and Emergency Care, Toho University School of Medicine, Omori Hospital, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo, Japan.
Background/Aims:
Gastric bubble is present in approximately 70% of normal chest and abdominal radiograph. Most swallowed air is regurgitated and belching is a physiological phenomenon to expel ingested gas from the stomach and is a common symptom in normal adults. In the present study it was investigated whether gastric bubble detected on abdominal radiograph is associated with GERD symptoms.
Methodology:
All of the patients who first attend our hospital were asked to respond the F-scale questionnaire regardless of their chief complaints to diagnose GERD. Plain abdominal films in the erect position were used to measure the size of gastric bubble and to classify the form of gastric bubble into four groups: dome-type; irregular-type; stomach-type; and undetected-type. The quantity of gastric bubble (gastric bubble score) was determined as the pixel value on image collected from hospital's digital database.
Results:
The gastric bubble score of irregular-type was significant lower than that of dome-type and stomach-type. GERD was most frequently detected in stomach-type group, followed by undetected-type, irregular-type, and dome-type. The mean score of F-scale was significantly higher in stomach-type than in dome-type.
Conclusions:
It is concluded that gastric bubble detected on plain abdominal films is an informative marker for evaluating the functional disorder of upper digestive tracts. Physicians have to recognize the importance of plain films of the abdomen in the diagnostic process of GERD.
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