Clinical, endoscopic and manometric features of the primary motor disorders of the esophagus

Abstract

BackgroundSignificant incidence, diagnostic difficulties, clinical relevance and therapeutic efficacy associated with the small number of publications on the primary esophageal motor disorders, motivated the present study.AimTo determine the manometric prevalence of these disorders and correlate them to the endoscopic and clinical findings.MethodsA retrospective study of 2614 patients, being 1529 (58.49%) women and 1085 (41.51%) men. From 299 manometric examinations diagnosed with primary esophageal motor disorder, were sought-clinical data (heartburn, regurgitation, dysphagia, odynophagia, non-cardiac chest pain, pharyngeal globe and extra-esophageal symptoms) and/or endoscopic (hiatal hernia, erosive esophagitis, food waste) that motivated the performance of manometry.ResultsWere found 49 cases of achalasia, 73 diffuse spasm, 89 nutcracker esophagus, 82 ineffective esophageal motility, and six lower esophageal sphincter hypertension. In relation to the correlations, it was observed that in 119 patients clinical conditions were associated with dysphagia, found in achalasia more than in other conditions; in relationship between endoscopic findings and clinical conditions there was no statistical significance between data.ConclusionsThe clinical and endoscopic findings have little value in the characterization of the primary motor disorders of the esophagus, showing even more the need for manometry, particularly in the preoperative period of gastroesophageal reflux disease.

Preoperative Manometry for the Selection of Obese People Candidate to Sleeve Gastrectomy

“…A control group was constituted in this research, due to the fact that manometric changes in the esophagus can occur in non-obese asymptomatic individuals 13 , 14 , 24 , 25 .…”

A Pictorial Presentation of Esophageal High Resolution Manometry Current Parameters

“…Conventional manometry measured LES relaxation at the nadir pressure 9 . This simple measurement may not distinguish a pseudorelaxation ( Figure 2 B) 6 .…”

“…CDP is the manometric representation of the transition from the esophageal body to the epiphrenic ampulla regarded as an inflection of the peristaltic axis in the topographic pressure graphic, which corresponds to the place where a change in bolus propulsion speed occurs ( Figure 5 ) 13 . CDP can be difficult to locate, therefore, Chicago Classification version 3.0 limited the localization of the CDP within 3 cm of the proximal margin of LES, in cases of atypical peristalsis 9 .…”