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Oesophageal manometry

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
David R Mitchell, Mohammad H Derakhshan, Angela A Wirz, Clare Orange, Stuart A Ballantyne, James J Going, Kenneth E L McColl
OBJECTIVE: Gastric acid secretory capacity in different anatomical regions, including the postprandial acid pocket, was assessed in Helicobacter pylori positive and negative volunteers in a Western population. DESIGN: We studied 31 H. pylori positive and 28 H. pylori negative volunteers, matched for age, gender and body mass index. Jumbo biopsies were taken at 11 predetermined locations from the gastro-oesophageal junction and stomach. Combined high-resolution pH metry (12 sensors) and manometry (36 sensors) was performed for 20 min fasted and 90 min postprandially...
September 23, 2016: Gut
A Jell, D Wilhelm, D Ostler, H Feußner, N Hüser
Diagnosis of oesophageal motility disorders has been well established for many years now, although circadian gastrointestinal motility is still purely understood. So far, high-resolution manometry (HRM) is only available for short-term measurement in clinical practice to evaluate simultaneous pressure conditions throughout the esophagus. Thus, only a very limited period of time can be investigated. There is evidence that disorders in esophageal motility can cause severe discomfort and symptoms even though they only tend to occur spontaneously...
September 2016: Zeitschrift Für Gastroenterologie
D Vijayaraju, G Prakash, T Yoganandh, S R Subramanian, S Ramkumar
A 50 year old male presented with progressive difficulty in swallowing both liquid and solid food with no history of Raynaud's phenomenon. A general examination revealed skin changes in the form of thickening, hyperpigmentation and tightening of skin of fingers, hand, forearm and legs. The patient had painless skin induration over the legs, forearm and hand. Salt and pepper pigmentation was seen on the upper back (Figure 1a), over mastoid process (Figure 1b) and the concha of pinna (Figure 1c). Anti-Scl 70 was positive...
September 2015: Journal of the Association of Physicians of India
Jacqui E Allen
PURPOSE OF REVIEW: The purpose of the review is to examine current research focused on upper oesophageal sphincter (UES) and cricopharyngeus muscle function, and how better understanding UES physiology will translate to improved management. RECENT FINDINGS: Although much is known about UES function, new information describing the dynamics of the UES and cricopharyngeus is being identified through manometry, combined fluoromanometry, and anatomic study. Response of the UES to injury, reflux, and surgical interventions is reported...
December 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Yu-Wen Li, Chen-Xi Xie, Kai-Ming Wu, Min-Hu Chen, Ying-Lian Xiao
BACKGROUND: Defects in distal oesophageal peristalsis was thought to be an indication of incomplete bolus transit (BT). However, the role of transition zone (TZ) defects in the BT in gastroesophageal reflux disease (GORD) patients needs clarification. The aim of this study was to assess the TZ defects in GORD patients and to explore the relationship between TZ defects and BT. METHODS: One hundred and two patients with reflux symptoms and 20 healthy adults were included in the study...
August 30, 2016: BMC Gastroenterology
Sílvia Roure, Lluís Valerio, Xavier Vallès, Betty Morales, M Immaculada Garcia-Diaz, M Luisa Pedro-Botet, Jordi Serra
BACKGROUND: Immigration-related new diseases pose a growing challenge for healthcare services in receptor countries. Following Latin American migration, Chagas disease has inevitably appeared in Europe. AIM: To determine the prevalence and characteristics of oesophageal motility disorders in immigrants infected with Trypanosoma cruzi, using high resolution oesophageal manometry (HREM). METHODS: In all newly-diagnosed cases with chronic Chagas infection referring upper digestive symptoms, a protocolized clinical evaluation and complementary tests including barium oesophagogram and HREM were carried out...
August 2016: United European Gastroenterology Journal
Anne-Laure Mallet, Alain Ropert, Guillaume Bouguen, Laurent Siproudhis, Dominique Boutroux, Jean-François Bretagne, Charlène Brochard
BACKGROUND: An association between acid gastro-oesophageal reflux disease (GERD) and Jackhammer oesophagus has been suggested. AIM: To assess the prevalence and characteristics of acid-GERD in Jackhammer oesophagus and the efficacy of proton pump inhibitors. METHODS: Data and outcomes of patients with Jackhammer oesophagus were assessed. Two groups were compared: (i) GERD, defined by endoscopic oesophagitis or by an increase in acid exposure time or by an acid-hypersensitive oesophagus and (ii) non-GERD defined by normal oesophageal acid exposure without acid-hypersensitive oesophagus...
October 2016: Digestive and Liver Disease
Basak Erginel, Feryal Gun Soysal, Erbug Keskin, Alaaddin Celik, Tansu Salman
Introduction The aim of this study was to review a single institution's experience with surgical interventions in children with achalasia and to determine treatment strategies for this rare disorder. Patients and methods This study is a retrospective analysis of 22 cases of childhood achalasia from 1991 to 2013. The patients were evaluated in terms of age, symptoms, interventions, intraoperative complications, and recurrent dysphagia. Results There were 13 boys and nine girls (7 months to 17 years old). The clinical symptoms were vomiting (68%), dysphagia (36%), wheezing (18%), coughing (13%), and weight-loss (13%)...
February 2016: Acta Chirurgica Belgica
E V Savarino, S Tolone, O Bartolo, C de Cassan, R Caccaro, F Galeazzi, L Nicoletti, R Salvador, M Martinato, M Costantini, V Savarino
BACKGROUND: Little is known about the relationship between proton pump inhibitor-responsive oesophageal eosinophilia (PPI-REE), eosinophilic esophagitis (EoE) and gastro-oesophageal reflux disease (GERD). AIM: To compare high resolution manometry features and symptom profiles of patients with EoE, PPI-REE and GERD. METHODS: Consecutive patients diagnosed with EoE or PPI-REE according to international criteria (presence of at least one typical symptom of oesophageal dysfunction; at least 15 eosinophils per high-power field at mid/proximal oesophagus, persistence or resolution of eosinophils after an 8-week PPI trial), and a group of patients with proven GERD and oesophageal eosinophilia, prospectively completed the GerdQ questionnaire and underwent high resolution manometry...
September 2016: Alimentary Pharmacology & Therapeutics
Lei Yu, Ji-Xiang Wu, Xiao-Hong Chen, Yun-Feng Zhang, Ji Ke
OBJECTIVE: Most researchers believe that the presence of large epiphrenic diverticulum (ED) with severe symptoms should lead to the consideration of surgical options. The choice of minimally invasive techniques and whether Heller myotomy with antireflux fundoplication should be employed after diverticulectomy became points of debate. The aim of this study was to describe how to perform laparoscopic transhiatal diverticulectomy (LTD) and oesophagomyotomy with the aid of intraoperative gastrointestinal (GI) endoscopy and how to investigate whether the oesophagomyotomy should be performed routinely after LTD...
October 2016: Journal of Minimal Access Surgery
Elaine V Robertson, Mohammad H Derakhshan, Angela A Wirz, David R Mitchell, James J Going, Andrew W Kelman, Stuart A Ballantyne, Kenneth E L McColl
BACKGROUND AND AIMS: Hiatus hernia (HH) is a key mediator of gastro-oesophageal reflux disease but little is known about its significance in the general population. We studied the structure and function of the gastro-oesophageal junction in healthy volunteers with and without HH. METHODS: We compared 15 volunteers with HH, detected by endoscopy or MRI scan, but without gastro-oesophageal reflux disease with 15 controls matched for age, gender and body weight. Jumbo biopsies were taken across the squamocolumnar junction (SCJ)...
April 25, 2016: Gut
Naueen Akbar Chaudhry, Kamran Zahid, Roxana Coman, Qing Zhang
A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain. Initial oesophagogastroduodenoscopy (OGD) with biopsies demonstrated gastritis in absence of Helicobacter pylori A gastric emptying study, CT scan with pancreatic protocol and a colonoscopy revealed no concerning findings. Calcium channel blockers and proton pump inhibitors offered little improvement. A high-resolution oesophageal impedance manometry was performed, which was significant for jackhammer oesophagus with maximum distal contractile index 11 052 mm Hg-s-cm...
May 12, 2016: BMJ Case Reports
Kulwinder S Dua, Walter J Hogan, Abdul A Aadam, Mario Gasparri
BACKGROUND: Tissue-engineered extracellular matrix populated with autologous pluripotent cells can result in de-novo organogenesis, but the technique is complex, not widely available, and has not yet been used to repair large oesophageal defects in human beings. We aimed to use readily available stents and extracellular matrix to regenerate the oesophagus in vivo in a human being to re-establish swallowing function. METHODS: In a patient aged 24 years, we endoscopically placed a readily available, fully covered, self-expanding, metal stent (diameter 18 mm, length 120 mm) to bridge a 5 cm full-thickness oesophageal segment destroyed by a mediastinal abscess and leading to direct communication between the hypopharynx and the mediastinum...
July 2, 2016: Lancet
Ilja Tachecí, Věra Radochová, Jaroslav Květina, Stanislav Rejchrt, Marcela Kopáčová, Jan Bureš
The aim of this study project was to prepare our own method of porcine oesophageal manometry. Ten mature experimental pigs entered the study. Conventional water-perfused system was decided for manometry. Porcine resting and relaxed pressures of the lower oesophageal sphincter are fully comparable with healthy human subjects. Evocable swallowing is doable and oesophageal peristalsis is quantifiable. Basic manometric parameters were different in male and female animals. Oesophageal manometry in experimental pigs is feasible...
2015: Acta Medica (Hradec Králové)
Jasmin Raja, Chin Teck Ng, Ibrahim Sujau, Kin Fah Chin, Sargunan Sockalingam
OBJECTIVES: To evaluate the associations between objectively measured gastroesophageal involvement using high-resolution manometry and 24- hour impedance-pH study, and clinical presentations in systemic sclerosis (SSc) patients. METHODS: This cross-sectional study was conducted in University of Malaya Medical Centre (UMMC) with 31 consecutive SSc patients recruited into this study. Clinical symptoms of gastroesophageal involvement, high-resolution impedance-manometry and 24-hour impedance-pH monitoring were assessed...
September 2016: Clinical and Experimental Rheumatology
Ada Yessenia Molina Caballero, María Eugenia Villar Varela, Alberto Pérez Martínez, Lidia Ayuso González, Sara Hernández Martín, Concepción Goñi Orayen
INTRODUCTION: Oesophageal pH-monitoring allows the quantification of gastric reflux episodes in patients with gastroesophageal reflux disease (GERD). The accuracy of the test depends on correct positioning of the pH sensor 5 cm above the lower oesophageal sphincter (LES). The most precise manner to locate the LES is through prior determination by oesophageal manometry. However, because this technique is uncomfortable, mathematical formulas tend to be used in children. OBJECTIVES: To evaluate the applicability of paediatric formulas to estimate oesophageal length in adults and their effect on diagnostic accuracy...
April 2016: Gastroenterología y Hepatología
P Rossi, S Isoldi, S Mallardo, G Biscione, S Oliva, D Rossetti, S Lucarelli, S Cucchiara
BACKGROUND: Patients (pts) with eosinophilic esophagitis (EoE), a chronic immune-mediated disorder, may exhibit symptoms of disturbed food transit (i.e. dysphagia, impaction) or mimicking gastro-oesophageal reflux (GOR). We aimed at characterizing in EoE pts the intra-esophageal pH pattern with 24-h multichannel intraluminal impedance (MII-pH) as well as the esophageal motility with high-resolution manometry (EHRM) METHODS:: during a 30 month period we studied 57 patients (pts), median age 11 years (range: 7-16): 25 with EoE, diagnosed according to widely agreed criteria (JPGN 2014;58:107-18; ESPGHAN guidelines) and 32 with GOR disease (GORD)...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
R Turco, D Ummarino, E Miele, G Terrone, E Del Giudice, A Staiano
OBJECTIVES: Mechanism underlying the occurrence of Gastroesophageal reflux disease (GERD) in neurologically impaired children (NIC) is poorly understood. We sought to characterize, by Esophageal High Resolution Manometry (EHRM), alterations of esophageal motility associated with GERD in NIC and to compare with a group with a suspicion of GERD and normal psychomotor development (NDP). METHODS: EHRM and multichannel intraluminal impedance/pH-metry (MII/pH) were conducted in 7 NIC and 9 patients with suspicion of GERD and NPD...
October 2015: Journal of Pediatric Gastroenterology and Nutrition
Muzaffer Ilhan, Ahmet Danalioglu, Seda Turgut, Ozcan Karaman, Elif Arabaci, Ertugrul Tasan
INTRODUCTION: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. MATERIAL AND METHODS: The study was performed in an institutional referral centre at a tertiary care hospital...
2015: Endokrynologia Polska
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