This would identify structural etiologies for her dysphagia such as a mild peptic stricture which can be missed at endoscopy. It can also evaluate motility abnormalities such as reflux or assess for achalasia by measuring the duration of barium emptying. If the barium swallow showed reflux, performing a 24 hour pH study while she is on therapy would let you know if her symptoms were indeed secondary to acid reflux. An esophageal manometry would be indicated if the barium esophagram suggested achalasia. It would also be useful to look for motility disorders as an explanation for her chest pain after GERD had been ruled out.
Men tend to predominate in most series.
Barrett's has been reported in children. Her barium esophagram was normal except for reflux. To further evaluate the reflux, the patient had a 24 hour pH study while on anti-secretory therapy to assess the degree and amount of time she was experiencing gastroduodenal reflux. The percentage of time she had reflux was within normal, so her GERD was well controlled and not the cause of her chest pain. Chest pain could be related to a motility disorder and the next step was performing an esophageal manometry.