Cervical esophageal webs: association with gastroesophageal reflux

Background: We investigated whether there is a significant association betw een cervical esophageal webs and gastroesophageal reflux on pharyngoesophag ography. Methods: We studied 50 patients with cervical esophageal webs on pharyngoes ophagrams and 50 control subjects. The control group was matched to the web s group for age, sex. and symptomatology. Patients with cervical esophageal webs and controls were compared to determine the prevalence of gastroesoph ageal reflux, hiatal hernias, reflux esophagitis, and abnormal esophageal m otility. Pearson's chi-square test was used to determine any statistically significant differences in the frequencies of these findings between groups . Results: Thirty-nine (78%) of 50 patients with cervical esophageal webs ver sus 27 (54%) of 50 patients in the control group had gastroesophageal reflu x (p = 0.01). When patients were classified based on degree of gastroesopha geal reflux, 22 (44%) of 50 patients with cervical esophageal webs versus 2 1 (42%) of 50 controls had mild reflux (p = 0.84), whereas 17 (34%) of 50 p atients with webs versus six (12%) of 50 controls (p < 0.009) had moderate/ marked reflux. Thus, the prevalence of moderate/marked gastroesophageal ref lux was significantly greater in patients with webs than in the controls. H owever, no significant differences were found in the prevalence of mild gas troesophageal reflux, hiatal hernias, reflux esophagitis, or abnormal esoph ageal motility. Conclusion: We found a significant association between cervical esophageal webs and gastroesophageal reflux independent of age, sex, or symptomatology . Radiologists should be aware of this association, so that patients with c ervical esophageal webs on pharyngoesophagography are evaluated for gastroe sophageal reflux at the time of the barium study or advised to undergo furt her testing for gastroesophageal reflux disease.