In 1977, a grading system of gastroesophageal reflux on barium study was devised it is based on the extent of retrograde flow of barium grade description i reflux into distal esophagus only ii reflux extending above carina iii reflux into cervical esophagus iv free persistent reflux into cervical esopagus with a wide open cardia (chalasia). Grades of gastroesophageal reflux radiology. Gerd grading radiology
