’Straight leg-raise’ improves diagnostic accuracy in GERD

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A recently published international study involving the Medical University of Vienna demonstrated that a straight leg-raise on the part of the patient significantly improved diagnostic accuracy in the work-up of gastro-oesophageal reflux disease (GORD or GERD). The scientific study by researchers at the University of Milan was published in the journal "Clinical Gastroenterology and Hepatology".

In their research, the international team observed that the diagnostic value of the standard method for evaluating oesophageal hypertension (high-resolution manometry) was significantly increased by using the "straight leg-raise" manoeuvre, where the patient simply elevates one leg while measurement is taking place. This manoeuvre causes an increase in intra-abdominal pressure and, independent of usual predictive factors such as the presence of a hiatus hernia, produced more accurate results.

"Experts in the field are currently discussing the possibility of incorporating this manoeuvre into the general guidelines for performing intra-oesophageal pressure measurement," says Ivan Kristo from the Division of Abdominal Surgery at MedUni Vienna’s Department of General Surgery, who co-authored the study. "Further studies are to follow as part of this international research project," explains Sebastian Schoppmann, Head of the Upper GI Service Unit at MedUni Vienna’s Department of General Surgery, who also co-authored the study on behalf of MedUni Vienna.

The statistics demonstrate the enormous relevance of research: around 20% of the Western population suffers from pathological gastroesophageal reflux, with the typical symptom of heartburn. Intra-oesophageal pressure measurement, along with acid measurement (pH-metry), is one of the typical tests used to diagnose reflux disease. An early and accurate diagnosis is essential, in order to initiate the appropriate treatment and prevent secondary disease as far as possible.

Publication: Clinical Gastroenterology and Hepatology
Improving the Diagnostic Yield of High-Resolution Esophageal Manometry for GERD: The "Straight Leg-Raise" International Study;
Stefano Siboni, Ivan Kristo, Benjamin D Rogers , Nicola De Bortoli, Anthony Hobson, Brian Louie, Yeong Yeh Lee, Vincent Tee, Salvatore Tolone, Elisa Marabotto, Pierfrancesco Visaggi, Jordan Haworth, Megan Ivy, Garrett Greenan, Chiara Facchini, Takahiro Masuda, Fumiaki Yano, Kyle Perry, Gokulakrishnan Balasubramanian, Dimitrios Theodorou, Tania Triantafyllou, Lorenzo Cusmai, Sara Boveri, Sebastian F Schoppmann, C Prakash Gyawali, Luigi Bonavina;
DOI: 10.1016/j.cgh.2022.10.008