VIDEO BARIUM SWALLOW OF "OESOPHAGUS"
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital,
Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai
Globus Hystericus is an obsolete term in
modern times. In olden days it was used for “Hysterical” patients complaining
of difficulty in swallowing!
In retrospect, I feel that all these patients had a motility disorder of the
oesophagus. The reason is as follows:
Oesophagus can be seen best by Endoscopy which can diagnose all the diseases
of this organ very accurately. The snag is that the motility disorder of this
organ will be missed by this procedure.
Similarly, routine barium meal studies, 24 hrs pH monitoring etc. cannot diagnose
motility disorders. The only investigation which can diagnose this disorder
hundred per cent is "manometry" studies which are not being done by
any private institution in Mumbai.
Thus "Video" Barium meal is a simple non-invasive method of picking
up patients having a motility disorder (specially in the upper oesophagus and
the adjoining area) provided you send your patient to a centre which has video
facility. An average radiologist will not be able to do the procedure. The results
are fairly accurate.
So next time, when you see a patient complaining of dysphagia and having all
normal reports, do not send him away without asking for this investigation.
GTN, Nifedipine and other drugs are now shown to give such patients some relief
from this distressing complaint.