Age and gender affect likely manometric diagnosis: Audit of a tertiary referral hospital clinical esophageal manometry service

Andrews, Jane M.; Heddle, Richard; Hebbard, Geoffrey; Checklin, Helen; Besanko, Laura K.; Fraser, Robert

doi:10.1111/j.1440-1746.2008.05561.x

Cited by 23 publications

(21 citation statements)

References 26 publications

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“…Gender does not influence whether esophageal motility is normal, spastic or with a non-specific motor disorder (1) .…”

Section: Introductionmentioning

confidence: 88%

“…A hipótese é que homens e mulheres têm diferenças na motilidade do esôfago. Métodos -Manometria de alta resolução foi realizada em voluntários saudáveis, 10 homens [média de idade: 37,7 (8,1) anos] e 12 mulheres [média de idade: 38,7 (7,5) anos], na posição sentada e com 10 deglutições de 5 mL de solução salina. Foram avaliadas a pressão integrada de relaxamento do esfíncter inferior do esôfago, velocidade da contração peristáltica, integral da contração distal, latência distal, extensão da contração proximal, duração da contração proximal >30 mmHg, duração da contração proximal, integral da contração proximal, pressão máxima do esfíncter superior do esôfago.…”

Section: Author' Contributionsunclassified

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Esophageal Motility in Men and Women Evaluated by High-Resolution Manometry

Costa

Dantas

2017

Arq. Gastroenterol.

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-Background -Esophageal motility has been described in the literature as having differences between men and women. Most of these investigations use the water perfusion method for esophageal manometry. In this investigation the esophageal motility of men and women was compared with high-resolution manometry of the esophagus. Objective -To compare the esophageal motility of men and women with the high-resolution manometry method for esophageal manometry, performed in the sitting position. The hypothesis was that men and women have differences in esophageal motility. Methods -High-resolution manometry was performed in normal volunteers, 10 men [mean age: 37.5 (8.1) years] and 12 women [mean age: 38.7 (7.5) years], in the sitting position and with 10 swallows of a 5 mL bolus of saline, with an interval of at least 30 seconds between consecutive swallows. We evaluated the integrated relaxation pressure of the lower esophageal sphincter, contraction front velocity, distal contraction integral, distal latency, proximal contraction extension, proximal contraction duration >30 mmHg, proximal contraction duration, proximal contraction integral and maximal upper esophageal sphincter pressure. Results -There was no significant difference between men and women in the variables measured. Conclusion -There was no difference in esophageal motility of men and women evaluated by the high resolution manometry method, in the sitting position with swallows of a liquid bolus. HEADINGS -Gastrointestinal motility. Manometry, methods. Sex factors.

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“…Gender does not influence whether esophageal motility is normal, spastic or with a non-specific motor disorder (1) .…”

Section: Introductionmentioning

confidence: 88%

Section: Author' Contributionsunclassified

Esophageal Motility in Men and Women Evaluated by High-Resolution Manometry

Costa

Dantas

2017

Arq. Gastroenterol.

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“…2, 7, 8, 9, 10, 11, 12, 13, 14 On the other hand, there are studies that show different results even though their data do not disprove some association between GERD and IEM, but rather declare that IEM is not standing alone as a cause of GERD. 15, 16, 17 Other hypotheses suggest an association with rapid food intake, 18, 19 Vagal hyper-reactivity, 20 advanced age, 21, 22 or damage to the enteric nervous system or smooth muscle 16 as possible etiologies. Furthermore, patient demographics such as age, sex, and race of afflicted patients are subjects of debate.…”

Section: Introductionmentioning

confidence: 99%

Manometric Subtypes of Ineffective Esophageal Motility

Hiestand

Jalil

Castell

2017

Clinical and Translational Gastroenterology

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Objectives:Ineffective esophageal motility (IEM) is characterized by well-defined manometric criteria. However, much variation exists within the diagnosis: Some patients exhibit exactly the required five weak swallows to make the diagnosis. Others show consistently ineffective swallows with total absence of any normal swallow. “We hypothesize” there are two different manometric subtypes of IEM; IEM Alternans (IEM-A) and IEM Persistens (IEM-P).Methods:A total of 231 IEM patients were identified by high-resolution manometry (HRM). IEM defined by distal contractile integral (DCI) <450 mm Hg/s/cm in ≥50% of test swallows. Abnormal reflux study was defined by excess total number of reflux episodes, abnormal esophageal acid exposure, or positive symptom association.Results:A total of 195 (84%) patients had IEM-A and 36 (16%) had IEM-P. A striking gender difference with 34% of IEM-A being males compared to 53% of IEM-P. (P=0.03). Mean age of IEM-P (59.6 years+/−13.1) was greater than IEM-A (55.5 years+/−13.6) (P=0.04). Mean lower esophageal sphincter (LES) resting pressure was significantly lower in IEM-P (20.8 mm Hg+/−1.4) than IEM-A (29 mm Hg+/−1.2) (P=0.002). There was no difference in LES-integrated relaxation pressure (IRP), bolus transit, or manometric presence of hiatal hernia between the two groups. Out of 146, 89 (61%) patients had abnormal reflux study. Esophageal acid exposure in upright position was significantly higher in IEM-P than IEM-A (3.5 vs. 1.7%, P=0.04). Poor gastric acid control on proton pump inhibitor (PPI) was more prevalent among IEM-P patients (58%) than IEM-A (27%) (P=0.007). In subgroup analysis of 41 IEM patients with dysphagia, DCI for liquid swallows was significantly lower in IEM-P (111+/−142 mm Hg/s/cm) compared to IEM-A (421+/−502 mm Hg/s/cm) (P=0.04), lower mean LES resting pressure in IEM-P (16.6+/−9 mm Hg) than IEM-A (31.7+/−18 mm Hg) (P=0.01).Conclusions:There are two distinct manometric IEM subtypes; IEM-P with an older male predominance, more advanced reflux disease, weaker LES, and worse response to PPI; likely a more advanced manifestation than IEM-A. However, the question if there are different etiologies underlying the two subtypes remains to be answered.

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“…Although esophageal manometry is widely used in clinical practice, the normal range of esophageal contraction parameters still is poorly defined [28]. Furthermore, esophageal manometry is known as a subtle and sensitive method, and different results are found to be dependent on the age and gender of patients [29]. The usage of wet, dry, or solid swallows also have significant influence on results, as also do different time intervals between two swallows.…”

Section: Discussionmentioning

confidence: 99%