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high-resolution manometry

Ciro Andolfi, Gyorgy Baffy, P Marco Fisichella
In the past decade, the introduction of high-resolution manometry and the classification of achalasia into subtypes has made possible to accurately diagnose the disease and predict the response to treatment for its different subtypes. However, even to date, in an era of exponential medical progress and increased insight in disease mechanisms, treatment of patients with achalasia is still rather simplistic and mostly confined to mechanical disruption of the lower esophageal sphincter by different means. In addition, there is partial consensus on what is the best form of available treatments for patients with achalasia...
August 2018: Journal of Surgical Research
Magnus Halland, John Pandolfino, Elizabeth Barba
Rumination syndrome is a functional gastrointestinal disorder characterized by effortless post-prandial regurgitation. The disorder appears uncommon, although only limited epidemiological data are available. Awareness of the characteristic symptoms is essential for recognizing the disorder, and thus avoiding the long delay in diagnosis which many patients experience. Whilst objective testing by post-prandial esophageal high resolution impedance manometry is available in select referral centers, a clinical diagnosis can be made in most patients...
June 11, 2018: Clinical Gastroenterology and Hepatology
Henriette Heinrich, Benjamin Misselwitz
Functional anorectal disorders such as faecal incontinence (FI), functional anorectal pain, and functional defecation disorders (FDD) are highly prevalent and represent a high socioeconomic burden. Several tests of anorectal function exist in this setting; however, high-resolution anorectal manometry (HR-ARM) is a new tool that depicts pressure all along the anal canal and can assess rectoanal coordination. HR-ARM is used in the diagnosis of FI and especially FDD although data in health is still sparse, and pressure phenomena seen during simulated defecation, such as dyssynergia, are highly prevalent in health...
April 2018: Visceral Medicine
Ines Gockel, Sebastian Murad Rabe, Stefan Niebisch
Background: Indications for benign esophageal surgery and postoperative follow-up need to be highly elaborated with differentiated and structured algorithms, based on objective functional workup in the esophageal laboratory. Functional outcome is of utmost interest and has to be driven by the need for comprehensive but purposeful diagnostic methods. Methods: Preoperative diagnostic workup procedures by the functional laboratory include 24-h pH-monitoring, impedance testing, and high-resolution manometry (HRM) - in addition to upper gastrointestinal endoscopy and barium swallow/timed barium esophagogram...
April 2018: Visceral Medicine
Jutta Keller
International guidelines agree that high-resolution esophageal manometry (HRM) is an integral part of the diagnostic evaluation of patients with refractory reflux symptoms and should be performed before antireflux surgery. Its most important goal is to explore differential diagnoses, in particular major esophageal motility disturbances, that may be responsible for symptoms. HRM additionally provides insights into all relevant pathomechanisms of gastroesophageal reflux disease (GERD): It can reveal important information on the morphology and function of the esophagogastric junction (EGJ), the presence of a hiatus hernia, transient lower esophageal sphincter relaxations, and dysmotility of the esophageal body...
April 2018: Visceral Medicine
Sergey Morozov, Vasily Isakov, Mariya Konovalova
AIM: To investigate the effect of dietary fiber on symptoms and esophageal function testing parameters in non-erosive gastroesophageal reflux disease (GERD) (NERD) patients. METHODS: Thirty-six NERD patients with low (< 20 g/d) dietary fiber intake were enrolled in the study. They were examined with the use of symptom questionnaire (GERD-Q), high-resolution esophageal manometry, 24-h esophageal pH-impedance examinations, and food frequency questionnaire before and after 10 d of usual diet supplemented by psyllium 5...
June 7, 2018: World Journal of Gastroenterology: WJG
Yeong Yeh Lee, Askin Erdogan, Siegfried Yu, Annie Dewitt, Satish S C Rao
Background/Aims: Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known. Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon...
June 7, 2018: Journal of Neurogastroenterology and Motility
Mark R Fox, Peter J Kahrilas, Sabine Roman, C Prakash Gyawali, S Mark Scott, Satish S Rao, Jutta Keller, Michael Camilleri
Symptoms related to abnormal gastrointestinal motility and function are common. Oropharyngeal and oesophageal dysphagia, heartburn, bloating, abdominal pain and alterations in bowel habits are among the most frequent reasons for seeking medical attention from internists or general practitioners and are also common reasons for referral to gastroenterologists and colorectal surgeons. However, the nonspecific nature of gastrointestinal symptoms, the absence of a definitive diagnosis on routine investigations (such as endoscopy, radiology or blood tests) and the lack of specific treatments make disease management challenging...
June 5, 2018: Nature Reviews. Gastroenterology & Hepatology
Yasutaka Kuribayashi, Toshiro Iizuka, Kosuke Nomura, Tsukasa Furuhata, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Toshifumi Mitani, Mitsuru Kaise, Shu Hoteya
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD. METHODS: HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference...
June 5, 2018: Digestion
J D G Cifuentes, P N Thota, R Lopez
Opiates can cause heartburn and spastic esophageal dysmotility but their role in noncardiac chest pain (NCCP) is not known. Our aim was to characterize opiate effects on esophageal function using esophageal pH monitoring and high-resolution manometry (HREM) in these patients.We performed a cross sectional study of opiate users with NCCP who underwent HREM and esophageal pH study from 2010 to 2017 using opiate nonusers as a comparison group. Demographic data, symptoms, opiate use, endoscopic findings, esophageal pH study parameters, and HREM data were abstracted...
May 26, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Max Schmulson
PURPOSE OF REVIEW: In 2016, the Rome IV process and criteria were published. They provide a system to standardize patient diagnostic requirements for clinical studies and pharmaceutical trials on functional gastrointestinal disorders (FGIDs), which are now called disorders of gut-brain interaction (DGBI). Although the Rome criteria have limitations in clinical practice, an understanding of the criteria can help clinicians to manage symptoms in patients with DGBI, and with organic diseases as well...
July 2018: Current Opinion in Gastroenterology
Antonio Ruiz de León San Juan
Lung transplants belong in the group of organ transplants with poorer outcomes, with acute rejection and bronchiolitis obliterans being cited as major causes of this. Poor allograft evolution has been associated with multiple factors, including those related to esophagogastric disease. In patients with end-stage pulmonary conditions eligible for a lung transplant gastroesophageal reflux (GER), esophageal dysmotily, and gastroparesis are highly prevalent and worsen upon transplantation, which may compromise transplant viability...
May 29, 2018: Revista Española de Enfermedades Digestivas
Ling Mei, Arshish Dua, Mark Kern, Siyuan Gao, Francis Edeani, Kulwinder Dua, Amy Wilson, Shaina Lynch, Patrick Sanvanson, Reza Shaker
BACKGROUND & AIMS: It is not clear how age affects airway protective mechanisms. We investigated the effects of aging on upper esophageal sphincter (UES) and esophageal body pressure responses to slow and ultra-slow simulated reflux events and post-reflux residue. METHODS: We performed a prospective study of 11 elderly (74±9 years old) and 11 young (28±7 years old) healthy volunteers. Participants were placed in a supine position and evaluated by concurrent high-resolution manometry, impedance manometry, and by an infusion technique...
May 24, 2018: Gastroenterology
J Bill, S Rajagopal, V Kushnir, C P Gyawali
Evaluation of dysphagia typically starts with esophagogastroduodenoscopy (EGD); further testing is pursued if this is negative. When no mucosal, structural, or motor esophageal disorders are identified with persisting symptoms, functional dysphagia is considered. We evaluated outcomes in patients undergoing EGD for dysphagia, and estimated prevalence of functional dysphagia. The endoscopy database at single tertiary care center was interrogated to identify EGDs performed for an indication of 'dysphagia' over a 12-month period (2008-09)...
May 24, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
M M Szczesniak, P I Wu, J Maclean, T I Omari, I J Cook
INTRODUCTION: Restrictive defects of the pharyngo-esophageal junction (PEJ) are common in both structural and neurological disorders and are amenable to therapies aiming to reduce outflow resistance. Intrabolus pressure (IBP) acquired with high-resolution manometry and impedance (HRMI) is an indicator of resistance and a marker of reduced PEJ compliance. Constraints and limitations of IBP as well as the optimal IBP parameter remain undefined. AIMS: To determine: (i) the impact of peak pharyngeal pressure (PeakP) on the diagnostic accuracy of IBP for the detection of a restrictive defect at the PEJ and (ii) the optimal IBP parameter for this purpose...
May 24, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
M Seo, S Joo, K W Jung, J Lee, H J Lee, J S Soh, I J Yoon, H S Koo, S Y Seo, D Kim, S W Hwang, S H Park, D-H Yang, B D Ye, J-S Byeon, H-Y Jung, S-K Yang, S S Rao, S-J Myung
BACKGROUND: Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. METHODS: A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests...
May 24, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Yuwei Li, Jiying Cong, Fei Fei, Zhao Zhang, Yongjun Yu, Chen Xu, Xipeng Zhang, Shiwu Zhang
BACKGROUND AND AIM: Different clinical treatments are available to treat patients with constipation. We aimed to study the etiology and direct treatment in a case series of patients with constipation by the use of high-resolution colonic manometry (HRCM). METHODS: HRCM was used to record the colorectal peristaltic contractions of the entire colon in patients. Based on the results of HRCM, 151 patients with constipation were classified into groups and received different clinical treatment such as a total or subtotal colectomy, local excision, or conservative treatment...
May 23, 2018: Journal of Gastroenterology and Hepatology
Shinwa Tanaka, Takashi Toyonaga, Fumiaki Kawara, Daisuke Watanabe, Namiko Hoshi, Hirohumi Abe, Ryusuke Ariyoshi, Yoshiko Ohara, Tsukasa Ishida, Toshitatsu Takao, Yoshinori Morita, Eiji Umegaki
A 73-year-old female with a 6-month history of progressive dysphagia and chest pain was referred to our hospital. She underwent esophagogastroduodenoscopy, which revealed abnormally strong contractions in the distal esophagus. Esophageal biopsy specimens showed massive eosinophil infiltration into the epithelium, and high-resolution manometry (HRM) also demonstrated abnormally strong contractions in the distal esophagus. Based on these results, she was diagnosed with Jackhammer esophagus (JHE) due to eosinophilic esophagitis (EoE)...
May 22, 2018: Clinical Journal of Gastroenterology
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
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
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