Chicago Classification normative metrics in a healthy Indian cohort for a 16‐channel water‐perfused high‐resolution esophageal manometry system

Srinivas, M; Jain, Mayank; Bawane, Piyush; Venkataraman, Jayanthi

doi:10.1111/nmo.13386

Cited by 11 publications

(6 citation statements)

References 18 publications

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“…The rest of the sensors are 3-cm apart spanning the length of the esophagus. 14 The tracings were analyzed using Trace 1.3.3 software after obtaining a minimum of 10 valid swallows (5 mL water) in the supine position. The following parameters were recorded: lower esophageal sphincter pressure (LES), integrated relaxation pressure (IRP), distal contractile integral, and distal latency (DL).…”

Section: High-resolution Esophageal Manometrymentioning

confidence: 99%

Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders

Nabi

Chavan

Ramchandani

et al. 2020

Journal of Clinical Gastroenterology

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Background and Aims: Spastic esophageal motility disorders (SEMD) are a rare group of motility disorders including type III achalasia, distal esophageal spasm (DES), and Jackhammer esophagus (JHE). Limited data suggest that per-oral endoscopic myotomy (POEM) may be effective in these disorders. In this study, we aimed to evaluate the long-term outcomes of POEM in SEMD. Methods: The data of patients with SEMD who underwent POEM (January 2013 to December 2019) were analyzed, retrospectively. The following outcomes were recorded: POEM procedure details, technical and clinical success, adverse events, and gastroesophageal reflux disease (GERD). Clinical success was classified as immediate (<1 y), short-term (1 to 3 y), medium term (3 to 5 y), and long-term (>5 y). Results: A total of 1115 POEM procedures were performed during the study period for achalasia and nonachalasia spastic motility disorders. POEM was performed for SEMD in 74 (6.6%) patients including type III in 53, DES in 11, and JHE in 10 patients. Technical success was achieved in all the patients. The median follow-up for the entire group was 47.5 months (range: 2 to 77 mo). Clinical success at short-term (1 to 3 y) and long-term follow-up (>5 y) was attained in 85.2% and 82.6% patients, respectively. There was no significant difference in the clinical success between type III achalasia and JHE/DES. Mild and moderate adverse events were recorded in 21 (28.4%) cases. GERD was detected in 23 (56.1%) patients with 24-hour pH study. Erosive esophagitis and symptomatic GERD were found in 36 (48.6%) and 16 (21.6%) patients, respectively. Conclusions: POEM is a safe, effective, and durable treatment modality for spastic motility disorders of the esophagus. However, GERD is found in about half of the patients mandating close monitoring after POEM.

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Section: High-resolution Esophageal Manometrymentioning

confidence: 99%

Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders

Nabi

Chavan

Ramchandani

et al. 2020

Journal of Clinical Gastroenterology

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“…As we have aforementioned, racial background and BMI affect HRM parameters. Different studies performed in Asian population 19,20,30,43 and European population 12,13 have found consistently lower values for DCI 95th percentile compared to studies performed in United States, 14‐16 these findings are important since DCI 95th value is relevant for diagnosing hypercontractile esophageal disorders, and using higher cutoff values may cause an under‐diagnosis in Asian and European population. Demographic factors are intrinsic to the population studied and, as such, cannot be modified; therefore, it is important to take into account demographic factors and how these variables can alter HRM results when interpreting studies performed on different populations.…”

Section: Discussionmentioning

confidence: 83%

Normative reference values for esophageal high‐resolution manometry in healthy adults: A systematic review

González

Nijhuis

Smout

et al. 2020

Neurogastroenterology Motil

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Esophageal manometry has been widely used to diagnose esophageal motility disorders. 1 It is the standard diagnostic tool in nonobstructive dysphagia, as it evaluates both pressures of the lower esophageal sphincter (LES) and contractility of the esophageal body. An important advancement in the last 20 years has been the introduction of high-resolution manometry (HRM), usually defined as manometry carried out with a catheter with at least 21 channels and with sensors at 1-cm intervals. 2 HRM is swiftly replacing conventional manometry, in which only a limited number of sensors (usually 4 to 8) are used. The generally perceived advantages of HRM over conventional manometry are that positioning of the catheter is less critical and that the interpretation of the recorded pressures, displayed in the form of topographical color-coded plots, is more intuitive. 3

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“…In our study, like others (6,8,12,(18)(19)(20)(21)(22)(23) , normal values were defined, dependent on what parameter studied, by the 5th and/or 95th percentile obtained in a population of healthy volunteers. Keeping in mind that this statistical analysis of results can induce, depending on the parameter, to a false abnormal result, simply by chance (5% or 10%).…”

Section: Discussionmentioning

confidence: 98%

Normal Values of Esophageal High-Resolution Manometry: A Brazilian Multicenter Study

Domingues

Michelsohn²,

Viebig³

et al. 2020

Arq. Gastroenterol.

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BACKGROUND: The high-resolution manometry has been a significant advance in esophageal diagnostics. There are different types of catheter and systems devices to capture esophageal pressures that generate variable data related to Chicago Classification (CC) and consequently influence normal values results. There are not normative data for the 24-channel water-perfused high-resolution manometry system most used in Brazil with healthy volunteers in supine posture. OBJECTIVE: To determine manometric esophageal normative values for a 24-channel water-perfused high-resolution manometry catheter in supine posture using healthy volunteers according to CC 3.0 parameters. METHODS: A total of 92 volunteers with no gastrointestinal symptoms or medications affecting GI motility underwent esophageal high-resolution manometry by standard protocol. Age, gender and manometry parameters analyzed using Alacer software were collected. The median, range, and 5th and 95th percentiles (where applicable) were obtained for all high-resolution manometry metrics. Normal value percentiles were defined as 95th integrated relaxation pressure, 5th-100th distal contractile integral, and 5th distal latency. RESULTS: The mean age was 40.5±13.2 years. Our normative metrics were integrated relaxation pressure <16 mmHg and distal contractile integral (708-4111 mmHg.cm.s) distal latency was <6 s and peristaltic break size (>4 cm). For EGJ-CI the range 5th-95th was 21.7-86.9 mmHg.cm.s. CONCLUSION: This is the first report of normative data for the 24-channel water-perfused system in supine posture. It revealed higher integrated relaxation pressure and distal latency duration which suggest the need to change CC 3.0 cutoffs for this system. It is observed that there is a tendency that DCI >7000 mmHg.cm.s may represent the lower limit of hypercontractility, and when <700 mmHg.cm.s (<5% percentile) interpreted as ineffective esophageal motility or failcontraction. Also compared to Chicago 3.0, higher integrated relaxation pressure and duration of distal latency were found. We emphasize that these data must be confirmed by future studies.

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Chicago Classification normative metrics in a healthy Indian cohort for a 16‐channel water‐perfused high‐resolution esophageal manometry system

Abstract: This is the first report of normative data for the 16-channel water-perfused system in supine posture. It revealed lower IRP and DCI, necessitating modification of CC cutoffs for this system.

Cited by 11 publications

References 18 publications

Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders

Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders

Normative reference values for esophageal high‐resolution manometry in healthy adults: A systematic review

Normal Values of Esophageal High-Resolution Manometry: A Brazilian Multicenter Study

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