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Oesophageal manometry

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https://www.readbyqxmd.com/read/29437910/modern-diagnosis-of-gerd-the-lyon-consensus
#1
REVIEW
C Prakash Gyawali, Peter J Kahrilas, Edoardo Savarino, Frank Zerbib, Francois Mion, André J P M Smout, Michael Vaezi, Daniel Sifrim, Mark R Fox, Marcelo F Vela, Radu Tutuian, Jan Tack, Albert J Bredenoord, John Pandolfino, Sabine Roman
Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET <4% and <40 reflux episodes on pH-impedance monitoring off proton pump inhibitors...
February 3, 2018: Gut
https://www.readbyqxmd.com/read/29177065/patients-with-symptoms-of-delayed-gastric-emptying-have-a-high-prevalence-of-oesophageal-dysmotility-irrespective-of-scintigraphic-evidence-of-gastroparesis
#2
George Triadafilopoulos, Linda Nguyen, John O Clarke
Background: Patients with symptoms suggestive of gastroparesis exhibit several symptoms, such as epigastric pain, postprandial fullness, bloating and regurgitation. It is uncertain if such symptoms reflect underlying oesophageal motor disorder. Aims: To examine whether patients with epigastric pain and postprandial distress syndrome suggestive of functional dyspepsia and/or gastroparesis also have concomitant oesophageal motility abnormalities and, if so, whether there are any associations between these disturbances...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29097867/dysphagia-thinking-outside-the-box
#3
REVIEW
Hamish Philpott, Mayur Garg, Dunya Tomic, Smrithya Balasubramanian, Rami Sweis
Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal dysfunction, the risk of aspiration, as well as chronic disabling gastroesophageal reflux (GORD). The predominant causes of dysphagia varies between cohorts depending on the interplay between genetic predisposition and environmental risk factors, and is changing with time. Currently in white Caucasian societies adopting a western lifestyle, obesity is common and thus associated gastroesophageal reflux disease is increasingly diagnosed...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29089268/oesophageal-motor-function-in-chronic-intestinal-idiopathic-pseudo-obstruction-a-study-with-high-resolution-manometry
#4
Aurelio Mauro, Guido Basilisco, Marianna Franchina, Alessandra Elvevi, Delia Pugliese, Dario Conte, Roberto Penagini
BACKGROUND: Chronic intestinal idiopathic pseudo-obstruction (idiopathic CIPO) is a rare heterogeneous condition for which the different phenotypes are difficult to be established. Oesophageal motility has shown to be impaired in patients with idiopathic CIPO at traditional manometry, whereas no studies have assessed it by high resolution manometry (HRM). AIMS: To evaluate oesophageal motility by HRM in patients with idiopathic CIPO. METHODS: 14 patients with idiopathic CIPO underwent oesophageal HRM...
October 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28951582/expert-consensus-document-advances-in-the-physiological-assessment-and-diagnosis-of-gerd
#5
REVIEW
Edoardo Savarino, Albert J Bredenoord, Mark Fox, John E Pandolfino, Sabine Roman, C Prakash Gyawali
GERD is a common condition worldwide. Key mechanisms of disease include abnormal oesophagogastric junction structure and function, and impaired oesophageal clearance. A therapeutic trial of acid-suppressive PPI therapy is often the initial management, with endoscopy performed in the setting of alarm symptoms and to exclude other conditions. If symptoms persist and endoscopy does not reveal evidence of GERD, oesophageal function tests are performed, including oesophageal manometry and ambulatory reflux monitoring...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28951579/expert-consensus-document-advances-in-the-management-of-oesophageal-motility-disorders-in-the-era-of-high-resolution-manometry-a-focus-on-achalasia-syndromes
#6
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Mark Fox, C Prakash Gyawali, Sabine Roman, André J P M Smout, John E Pandolfino
High-resolution manometry (HRM) and new analysis algorithms, summarized in the Chicago Classification, have led to a restructured classification of oesophageal motility disorders. This advance has led to increased detection of clinically relevant disorders, in particular achalasia. It has become apparent that the cardinal feature of achalasia - impaired lower oesophageal sphincter (LES) relaxation - can occur in several disease phenotypes: without peristalsis (type I), with pan-oesophageal pressurization (type II), with premature (spastic) distal oesophageal contractions (type III), or with preserved peristalsis (outlet obstruction)...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28869413/severe-oesophageal-disease-and-its-associations-with-systemic-sclerosis
#7
Georgios P Karamanolis, Konstantinos Denaxas, Stylianos Panopoulos, Kalliopi-Vasiliki Bournia, Alexandra Zorbala, Dimitrios Kamberoglou, Dimitrios Schizas, Spiros D Ladas, Petros P Sfikakis
OBJECTIVES: Severe oesophageal disease in patients with systemic sclerosis (SSc), referred as scleroderma oesophagus, is characterised by ineffective or absent peristalsis along with hypotensive oesophagogastric junction (hEGJ). The associations between scleroderma oesophagus and different clinical and laboratory manifestations of SSc is still controversial. In this study we aimed to assess associations between scleroderma oesophagus, diagnosed by high resolution manometry (HRM), and other manifestations of disease...
August 30, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28851715/oesophageal-mastocytosis-eosinophilic-oesophagitis-without-eosinophils
#8
Donevan Westerveld, Jian Li, Sarah Glover
A 59-year-old male with a history of lifelong asthma, allergic rhinitis and hypercholesterolaemia presented to the emergency department for management of severe substernal chest pain with radiating pain to his left arm, nausea and diaphoresis. Physical examination was unrevealing and a cardiac workup including cardiac enzymes, ECG, chest radiographs were negative for an underlying ischaemic event. A subsequent gastrointestinal workup including oesophageal manometry and oesophagogastroduodenoscopy revealed elevated lower oesophageal pressures and histopathology suggestive of mast cell proliferation, respectively...
August 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#9
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28691686/oesophageal-dysphagia-a-stepwise-approach-to-diagnosis-and-management
#10
REVIEW
Brian T Johnston
Dysphagia is a common symptom in the general population. Incidence varies depending on the specific definition used. A good medical history is vital for distinguishing true oesophageal dysphagia from oropharyngeal dysphagia or other causes. Oesophageal dysphagia is a so-called red flag alarm symptom requiring oesophagogastroduodenoscopy. However, even after investigations including oesophagogastroduodenoscopy (with biopsy), barium swallow, and oesophageal manometry, no obstructive cause may be found. This Review suggests an algorithm of history-taking and investigation to allow the causes of non-obstructive dysphagia to be identified, including functional dysphagia...
August 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28684262/diagnostic-yield-of-high-resolution-manometry-with-a-solid-test-meal-for-clinically-relevant-symptomatic-oesophageal-motility-disorders-serial-diagnostic-study
#11
Daphne Ang, Benjamin Misselwitz, Michael Hollenstein, Kevin Knowles, Jeff Wright, Emily Tucker, Rami Sweis, Mark Fox
BACKGROUND: The use of high-resolution manometry (HRM) to diagnose oesophageal motility disorders is based on ten single water swallows (SWS); however, this approach might not be representative of oesophageal function during the ingestion of normal food. We tested whether inclusion of a standardised solid test meal (STM) to HRM studies increases test sensitivity for major motility disorders. Additionally, we assessed the frequency and cause of patient symptoms during STM. METHODS: Consecutive patients who were referred for investigation of oesophageal symptoms were recruited at Nottingham University Hospitals (Nottingham, UK) in the development study and at University Hospital Zürich (Zürich, Switzerland) in the validation study...
July 3, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28684261/pharyngeal-swallowing-and-oesophageal-motility-during-a-solid-meal-test-a-prospective-study-in-healthy-volunteers-and-patients-with-major-motility-disorders
#12
Michael Hollenstein, Philip Thwaites, Simon Bütikofer, Henriette Heinrich, Matthias Sauter, Irina Ulmer, Daniel Pohl, Daphne Ang, Daniel Eberli, Werner Schwizer, Michael Fried, Oliver Distler, Mark Fox, Benjamin Misselwitz
BACKGROUND: The factors that determine how people eat when they are healthy or have disease have not been defined. We used high resolution manometry (HRM) to assess pharyngeal swallowing and oesophageal motility during ingestion of a solid test meal (STM) in healthy volunteers and patients with motility disorders. METHODS: This study was based at University Hospital Zurich (Zürich, Switzerland). Healthy volunteers who responded to an advertisement completed HRM with ten single water swallows (SWS) in recumbent and upright positions followed by a 200 g rice STM in the upright position...
July 3, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28684260/oesophageal-manometry-with-a-solid-test-meal-ready-for-prime-time
#13
Philip O Katz, Felice Schnoll-Sussman
No abstract text is available yet for this article.
July 3, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28637650/achalasia-leading-to-diagnosis-of-adenocarcinoma-of-the-oesophagus
#14
Jonathan Segal, Ayodele Lagundoye, Martyn Carter
A 50-year-old male with a 7 month history of progressive dysphagia to solids then subsequently to liquids. He underwent a diagnostic gastroscopy which was normal. A further barium swallow suggested achalasia. He was referred to a tertiary centre, where he underwent pH and manometry studies which confirmed a diagnosis of achalasia. He was referred for a laparoscopic cardiomyotomy, and at surgery there was a suspected tumour at the gastro-oesophageal junction. A follow-up endoscopy with biopsies was normal...
June 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535800/comparison-of-oesophageal-function-tests-between-chinese-non-erosive-reflux-disease-and-reflux-hypersensitivity-patients
#15
Feng Gao, Yan Gao, Xue Chen, Jie Qian, Jie Zhang
BACKGROUND: By means of 24 h multi-channel intraluminal impedance and pH recording (MII/pH), patients with heartburn and normal upper gastrointestinal endoscopy findings can be classified into those with non-erosive reflux disease (NERD) and those with reflux hypersensitivity (RH). Therefore, in this study, we investigated the difference in oesophageal function tests in Chinese patients with NERD and RH. METHODS: NERD patients were selected from the digestive department, Beijing Anzhen Hospital and Beijing Chao-Yang Hospital, Capital Medical University, after upper gastrointestinal endoscope, high-resolution manometry and impedance (HRiM), and MII/pH examinations between 2014 and 2016...
May 23, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28447027/gastric-function-in-children-with-oesophageal-atresia-and-tracheoesophageal-fistula
#16
REVIEW
Gilles Duvoisin, Usha Krishnan
Oesophageal atresia and tracheoesophageal fistula (OA-TOF) are a multifaceted condition which affects patients throughout their lives. Even though it is one of the most common gastrointestinal malformations, most of the current studies focus on gastro-oesophageal reflux disease, anastomotic strictures, and feeding difficulties. However, there is increasing evidence that a proportion of patients with OA-TOF also have abnormal gastric function. This review aims to provide a comprehensive understanding of studies of gastric function in patients with OA-TOF...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28346382/the-balloon-based-manometry-evaluation-of-swallowing-in-patients-with-amyotrophic-lateral-sclerosis
#17
Jerzy Tomik, Barbara Tomik, Sebastian Gajec, Piotr Ceranowicz, Małgorzata Pihut, Rafał Olszanecki, Paweł Stręk, Jacek Składzień
The aim of the study was to analyse the disturbances of the oro-pharyngeal swallowing phase of dysphagia in amyotrophic lateral sclerosis (ALS) patients with the use of specific manometric measurements and to evaluate their plausible association with the duration of the disease. Seventeen patients with ALS were evaluated with manometric examinations of the oral and pharyngeal part of the gastrointestinal tract. Tests were carried out by using the oesophageal balloon-based method with four balloon transducers located 5 cm away from each other...
March 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28258931/the-effects-of-paroxetine-and-amitriptyline-on-the-upper-esophageal-sphincter-ues-pressure-and-its-natural-history-in-globus-pharyngeus
#18
Wen-Cong Zhou, Lin Jia, Dong-Yun Chen, Yao Liu, Jing Liu, Shu-Man Jiang, Meng Yang, Jian Xu
BACKGROUND: Antidepressant agents have been shown to be an effective and safe treatment method for patients with globus. However, there are few clinical trials dedicated to studying the effects of antidepressant agents on the natural history and upper oesophageal sphincter (UES) pressure of treated globus patients. AIMS: To evaluate the effect of paroxetine and amitriptyline to prevent relapses in patients with globus, the simultaneous relationship between changes in UES pressure and improvement of globus symptoms were measured...
July 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28252352/fundoplication-for-laryngopharyngeal-reflux-despite-preoperative-dysphagia
#19
G L Falk, H Van der Wall, L Burton, M G Falk, H O'Donnell, S J Vivian
INTRODUCTION Fundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards. METHODS This paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy. RESULTS Following careful patient selection, 33 patients underwent fundoplication by laparoscopy...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27859421/the-learning-curve-for-interpretation-of-oesophageal-high-resolution-manometry-a-prospective-interventional-cohort-study
#20
S Gaddam, C A Reddy, S Munigala, A Patel, N Kanuri, S Almaskeen, M K Rude, A Abdalla, C P Gyawali
BACKGROUND: High-resolution manometry has become the preferred choice of oesophagologists for oesophageal motor assessment, but the learning curve among trainees remains unclear. AIM: To determine the learning curve of high-resolution manometry interpretation. METHODS: A prospective interventional cohort study was performed on 18 gastroenterology trainees, naïve to high-resolution manometry (median age 32 ± 4.0 years, 44.4% female). An intake questionnaire and a 1-h standardised didactic session were performed at baseline...
January 2017: Alimentary Pharmacology & Therapeutics
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