Comparison of diagnostic methods for selection of patients for antireflux operations

In cases of reflux disease the therapeutic indications are of special significance. The number of patients in need of operation is limited, thus the patients must be chosen carefully. Different diagnostic methods have been compared to standard acid reflux test in a series of 22 consecutive cases. Radiology was the least reliable method for detecting reflux or reflux complications, whereas endoscopy confirmed the diagnosis in 18 of 22 cases. Three-point stepwise manometry did not give reliable data of the lower esophageal sphincter pressure but yielded valuable information about the location of lower esophageal sphincter zone and of esophageal motility. In contrasts to earlier reports, no considerable overlap regarding lower esophageal sphincter pressure values in healthy and diseased individuals were noted.