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Esophageal manometry

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https://www.readbyqxmd.com/read/29761528/nonerosive-reflux-disease-clinical-concepts
#1
REVIEW
C Prakash Gyawali, Dan E Azagury, Walter W Chan, Servarayan M Chandramohan, John O Clarke, Nicola de Bortoli, Edgar Figueredo, Mark Fox, Daniela Jodorkovsky, Adriana Lazarescu, Peter Malfertheiner, Jan Martinek, Kenric M Murayama, Roberto Penagini, Edoardo Savarino, Katerina P Shetler, Ellen Stein, Roger P Tatum, Justin Wu
Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH-impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux-symptom association...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29754440/indications-and-interpretation-of-esophageal-function-testing
#2
REVIEW
C Prakash Gyawali, Nicola de Bortoli, John Clarke, Carla Marinelli, Salvatore Tolone, Sabine Roman, Edoardo Savarino
Esophageal symptoms are common, and can arise from mucosal, motor, functional, and neoplastic processes, among others. Judicious use of diagnostic testing can help define the etiology of symptoms and can direct management. Endoscopy, esophageal high-resolution manometry (HRM), ambulatory pH or pH-impedance manometry, and barium radiography are commonly used for esophageal function testing; functional lumen imaging probe is an emerging option. Recent consensus guidelines have provided direction in using test findings toward defining mechanisms of esophageal symptoms...
May 12, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29753457/assessment-of-esophageal-function-using-provocative-tests-during-high-resolution-manometry-a-single-center-experience
#3
Ming-Wun Wong, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Chien-Lin Chen
BACKGROUND: Provocative tests were used to provide additional information during performing high resolution manometry (HRM). The study aimed to evaluate whether it is feasible to test esophageal function with different esophageal provocative tests during HRM. METHODS: 23 healthy volunteers (9 women; mean age 25 years, range 21-30 years) underwent water-perfused HRM. Each subject received 10 liquid swallows, 10 solid swallows, 10 liquid swallows with abdominal compression, and 5 multiple rapid swallowing (MRS)...
May 9, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29733830/genesis-of-esophageal-pressurization-and-bolus-flow-patterns-in-patients-with-achalasia-esophagus
#4
Subum Park, Ali Zifan, Dushyant Kumar, Ravinder K Mittal
BACKGROUND & AIMS: In patients with achalasia esophagus, swallows induce simultaneous pressure waves known as esophageal pressurization. We studied the mechanism of esophageal pressurization and bolus flow patterns in patients with type 2 or type 3 achalasia. METHODS: We recorded high-resolution manometry with impedance and intraluminal ultrasound images concurrently in patients with type 2 achalasia (n=6) or type 3 achalasia (n=8) and in 10 healthy subjects (controls) during swallows of 5 ml, 0...
May 4, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29712590/esophageal-achalasia-pathophysiology-clinical-presentation-and-diagnostic-evaluation
#5
Francisco Schlottmann, Rafael M L Neto, Fernando A M Herbella, Marco G Patti
Esophageal achalasia is a primary esophageal motility disorder characterized by the absence of esophageal peristalsis and failure of the lower esophageal sphincter to relax in response to swallowing. These abnormalities lead to impaired emptying of food from the esophagus into the stomach with resulting food stasis. Most patients experience severe dysphagia, and regurgitation can lead to aspiration and respiratory problems. Consequently, the quality of life of patients affected by achalasia is severely impacted...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29702296/advances-in-management-of-esophageal-motility-disorders
#6
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Dustin A Carlson, John E Pandolfino
The widespread adoption of high-resolution manometry (HRM) has led to a restructuring in the classification of esophageal motility disorder classification summarized in the Chicago Classification, currently in version 3.0. It has become apparent that the cardinal feature of achalasia, impaired lower esophageal sphincter relaxation, can occur in several disease phenotypes: without peristalsis, with premature (spastic) distal esophageal contractions, with panesophageal pressurization, or even with preserved peristalsis...
April 24, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29698944/mucosally-expressed-cytokines-are-associated-with-the-esophageal-motility-function
#7
Keita Fukaura, Eikichi Ihara, Haruei Ogino, Yoichiro Iboshi, Kazumasa Muta, Bai Xiaopeng, Shohei Hamada, Yoshitaka Hata, Tsutomu Iwasa, Akira Aso, Kazuhiko Nakamura, Yoshihiro Ogawa
BACKGROUND AND AIM: Although basic research has shown that certain cytokines affect gastrointestinal motility, the clinical evidence is lacking. The objective of this study was to explore the association between mucosally expressed cytokines and the esophageal motility function in humans. METHODS: We enrolled a total of 57 patients with suspected esophageal motility disorders (EMDs) who underwent high-resolution manometry. RESULTS: The diagnoses of the patients were as follows: normal esophageal motility (n = 25), ineffective esophageal motility (n = 5), esophagogastric junction outflow obstruction (EGJOO; n = 10), distal esophageal spasm (n = 5), achalasia (n = 10), absent contractility (n = 1), and jackhammer esophagus (n = 1)...
April 26, 2018: Digestion
https://www.readbyqxmd.com/read/29684933/-dysphagia-from-a-gastroenterologist-s-perspective
#8
Marcus Hollenbach, Jürgen Feisthammel, Joachim Mössner, Albrecht Hoffmeister
Swallowing disorders (dysphagia) comprise a common cause of medical consultation and are defined as a subjective sensation of difficulty or abnormality of swallowing. In the initial step, a clear differentiation of dysphagia from odynophagia and globus sensation for further diagnostic procedures is mandatory. The careful questioning of patients symptoms and complaints is often helpful for the differentiation of oropharyngeal and esophageal dysphagia. Oropharyngeal dysphagia is mainly caused by neurological disorders (cerebral ischemia, Parkinson's disease, dementia) or local compression of malignancies, thyroid gland or lymph nodes...
May 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29660156/evaluation-of-symptomatic-esophagogastric-junction-outflow-obstruction
#9
Andrew Ming Liang Ong, Vikneswaran Namasivayam, Yu Tien Wang
BACKGROUND: Esophagogastric junction outflow obstruction (EGJOO) may be due to anatomical abnormalities but it is unclear how to evaluate them after high resolution manometry (HRM). We aimed to determine 1) clinical and HRM parameters differentiating anatomical EGJOO from functional EGJOO, 2) investigations chosen and yield for anatomical EGJOO and 3) clinical outcomes of functional EGJOO. METHODS: Medical records of consecutive patients with symptomatic EGJOO from February 2012 to December 2015 were reviewed...
April 16, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29657705/laparoscopic-transhiatal-resection-of-a-large-mid-esophageal-diverticulum-a-case-report
#10
Tomislav Tokic, Iva Kirac, Davor Hrabar, Branko Troskot, Miroslav Bekavac-Beslin
This is a description of transhiatal laparoscopic approach for mid-esophageal diverticulum. Traditionally mid-esophageal diverticula are approached by thoracotomy or thoracoscopy, with the laparoscopic technique being reserved for epiphrenic diverticula. A 78-year-old Caucasian female with a secondary dilatative ischemic cardiomyopathy presented with dysphagia, tenderness in the epigastrium and a considerable weight loss. A large mid-esophageal diverticulum was found on barium swallow and confirmed by CT scan...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29644765/correlation-between-novel-3d-high-resolution-manometry-esophagogastric-junction-metrics-and-ph-metry-in-reflux-disease-patients
#11
Y Xiao, Z Lin, Y Li, J E Pandolfino, M Chen, P J Kahrilas
BACKGROUND AND AIMS: We recently developed 2 novel 3D high-resolution manometry (HRM) metrics of esophagogastric junction (EGJ) contractility to differentiate the lower esophageal sphincter (LES) and crural diaphragm (CD) elements of EGJ pressure. This study aimed to compare these metrics to the EGJ-contractile integral (EGJ-CI) and to analyze their correlation with esophageal acid exposure time (AET) on pH-metry. METHODS: Thirty-one gastro-oesophageal reflux disease (GERD) patients and 20 control subjects underwent 24-hour pH-metry and HRM using a 3D-HRM catheter...
April 11, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29643293/-a-case-of-non-cardiac-chest-pain-caused-by-esophageal-motility-disorder-observed-on-esophageal-high-resolution-manometry
#12
Kazumasa Muta, Eikichi Ihara, Yusuke Kitagawa, Shohei Hamada, Keita Fukaura, Tsutomu Iwasa, Akira Aso, Haruei Ogino, Kazuhiko Nakamura, Yoshihiro Ogawa
A 20-year-old man was referred to our hospital with dysphagia and chest pain. Heart disease was denied. No abnormality was observed in upper esophagogastroduodenoscopy and fluoroscopy;furthermore, no gastric acid-related symptoms were observed on combined esophageal multichannel intraluminal impedance and pH monitoring. Esophageal high-resolution manometry (HRM) performed by liquid swallow revealed normal peristalsis;however, HRM performed while the patient was taking solid meals showed abnormal contraction, and the patient simultaneously complained of chest pain...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/29617746/thoracoabdominal-pressure-gradient-and-gastroesophageal-reflux-insights-from-lung-transplant-candidates
#13
T Masuda, S K Mittal, B Kovacs, M Smith, R Walia, J Huang, R M Bremner
Advanced lung disease is associated with gastroesophageal reflux disease (GERD). The thoracoabdominal pressure gradient (TAPG) facilitates gastroesophageal reflux, but the effects of TAPG on gastroesophageal reflux in patients with pulmonary disease have not been well defined. Patients diagnosed with end-stage lung disease are expected to have the most extreme derangement in respiratory mechanics. The aim of this study is to explore the relationship between TAPG and reflux in lung transplant (LTx) candidates...
March 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29608597/a-clinical-study-of-peroral-endoscopic-myotomy-reveals-that-impaired-lower-esophageal-sphincter-relaxation-in-achalasia-is-not-only-defined-by-high-resolution-manometry
#14
Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai
BACKGROUND AND AIM: Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation. On high-resolution manometry (HRM), impaired LES relaxation is defined by elevated integrated relaxation pressure (IRP). However, a new category of achalasia within the normal IRP range has been suggested. METHODS: HRM was performed using a Starlet device and an IRP threshold of 26 mmHg. Peroral endoscopic myotomy (POEM) was performed for cases of achalasia diagnosed using established methods...
2018: PloS One
https://www.readbyqxmd.com/read/29605979/acotiamide-has-no-effects-on-esophageal-motor-activity-or-esophagogastric-junction-compliance
#15
Hironobu Mikami, Norihisa Ishimura, Mayumi Okada, Daisuke Izumi, Eiko Okimoto, Shunji Ishihara, Yoshikazu Kinoshita
Background/Aims: The novel prokinetic drug acotiamide is used for treatment of functional dyspepsia. It is still unclear how acotiamide has effects on esophageal motor function. Esophageal peristalsis and esophagogastric junction (EGJ) compliance has an important role for prevention of esophageal mucosal damage caused by gastroesophageal reflux, however, few studies have analyzed the effects of acotiamide on those former activities and none have investigated its effects on EGJ compliance...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29605977/esophageal-motor-disorders-are-a-strong-and-independant-associated-factor-of-barrett-s-esophagus
#16
Camille Bazin, Alban Benezech, Marine Alessandrini, Jean-Charles Grimaud, Veronique Vitton
Background/Aims: Esophageal motor disorder (EMD) has been shown to be associated with gastroesophageal reflux disease (GERD). However, the association of EMD with a Barrett's esophagus (BE) is controversial. Our objective was to evaluate whether the presence of EMD was an independent factor associated with BE. Methods: A retrospective case-control study was conducted in GERD patients who all had oeso-gastroduodenal endoscopy and high-resolution esophageal manometry...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29605727/abnormal-high-resolution-manometry-findings-and-outcomes-after-paraesophageal-hernia-repair
#17
Andrea Wirsching, Qing Zhang, Susan E McCormick, Michal Hubka, Donald E Low
BACKGROUND: Abnormal esophageal peristalsis diagnosed by high resolution manometry (HRM) is found frequently as part of the preoperative evaluation of paraesophageal hernia (PEH) patients. The clinical relevance of these findings is currently largely unknown. STUDY DESIGN: From 2013 to 2016, 212 patients undergoing PEH repair were prospectively recorded in an IRB approved database. Preoperative HRM was available for reanalysis according to the latest Chicago Classification (v...
March 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29605413/distal-esophageal-spasm-a-review
#18
REVIEW
Mohamed Khalaf, Sejal Chowdhary, Puja Sukhwani Elias, Donald Castell
Distal esophageal spasm is a rare motility disorder presenting principally with non-obstructive dysphagia and non-cardiac chest pain. In symptomatic patients, the manometric diagnosis is made when > 10% of the wet swallows have simultaneous and/or premature contractions intermixed with normal peristalsis. We characterize manometry and barium as complimentary diagnostic approaches, and given the intermittent nature of the disorder, one should be always aware that IT IS ALMOST IMPOSSIBLE TO RULE OUT SPASM...
March 29, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29603510/esophageal-provocation-tests-are-they-useful-to-improve-diagnostic-yield-of-high-resolution-manometry
#19
REVIEW
D A Carlson, S Roman
High resolution manometry (HRM) is the gold standard to diagnose esophageal motility disorders but has some limitations. The inclusion of provocative tests might enhance the diagnostic yield of HRM. These tests are easy to perform and to add to the regular manometry protocol. Multiple rapid swallows (MRS; 5 2-mL swallows) is useful to assess the contractile reserve and deglutitive inhibition. The optimal number of MRS to perform might be 3 as suggested by Mauro et al. in this issue of Neurogastroenterology & Motility...
April 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29602998/clinical-feasibility-of-a-new-full-thickness-endoscopic-plication-device-gerdx%C3%A2-for-patients-with-gerd-results-of-a-prospective-trial
#20
Michael Weitzendorfer, Georg O Spaun, Stavros A Antoniou, Kai Witzel, Klaus Emmanuel, Oliver O Koch
BACKGROUND: Previous studies suggest clinical effectiveness of endoscopic full-thickness plication in selected patients with gastroesophageal reflux disease (GERD). The aim of this study was to assess the clinical safety and efficiency of the GERDx™ device by evaluating clinical parameters, reflux symptom scores, and quality of life (QoL). METHODS: Prospective one-arm trial evaluating the outcome of forty patients with GERD subjected to endoscopic plication with the GERDx™ device...
March 30, 2018: Surgical Endoscopy
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