New technologies in the gastrointestinal clinic and research: Impedance and high-resolution manometry

Pandolfino, John E.; Kahrilas, Peter J.

doi:10.3748/wjg.15.131

Cited by 42 publications

(45 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, the direction, power and peristalsis of intra-esophageal pressure as presented in spatiotemporal plots allow clinicians to distinguish an abnormal from a normal esophageal motility pattern. [11][12][13] Therefore, a high-resolution system is characterized by: (1) a simplified set up with improved sphincter localization, (2) elimination of movement artifacts, (3) simplified data interpretation, (4) the ability to perform a more sophisticated analysis 14 , and (5) ease of reporting and storing the patient reports due to use of dedicated software.…”

Section: Discussionmentioning

confidence: 99%

Comparison of High-resolution Anorectal Manometry With Water-perfused Anorectal Manometry

Kang

Lee

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/Aims To date, high-resolution manometry has been used mainly in the study of esophageal motility disorders and has been shown to provide more physiological information than conventional manometry, and is easier to interpret. This study aimed to evaluate the usefulness of high-resolution anorectal manometry (HRARM) compared to water-perfused anorectal manometry. Methods Patients who complained of chronic constipation with/without fecal incontinence underwent both water-perfused anorectal manometry and HRARM in a random order on the same day. Resting and squeezing pressures of the anal sphincter, attempted defecation, rectoanal inhibitory reflex, rectoanal contractile reflex, Rao’s type of dyssynergia during attempted defecation, anal canal length, defecation dynamic parameters and measurement times for each method were analyzed. Results Of 14 patients, 7 were female, and the median age was 59 years (range 35–77). Indications for manometry were constipation (n = 8) and constipation with fecal incontinence (n = 6). Resting and squeezing pressures showed that the 2 methods were strongly correlated (resting pressure: r = 0.746, P = 0.002; squeezing pressure: r = 0.921, P < 0.001). In attempted defection, one equivocal case with water-perfused anorectal manometry was diagnosed type I pelvic floor dyssynergia with HRARM providing detailed pressure changes in internal and external anal spincters, and puborectalis muscle which improved assessment of anorectal disorders. The measurement time for HRARM was significantly shorter than that for water-perfused anorectal manometry (11.3 vs 23.0 minutes, P < 0.001). Conclusions Both water-perfused anorectal manometry and HRARM are well tolerated and reliable methods of evaluating defecation disorders of pelvic floor dysfunction. HRARM is likely to provide better physiological information and to require a shorter measurement time compared to water-perfused anorectal manometry.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of High-resolution Anorectal Manometry With Water-perfused Anorectal Manometry

Kang

Lee

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…[7][8][9] The test is usually performed in the supine position. 6,10 The published normative reference values are for this position too and the Chicago classification 7 is applied to them. Recently a European group has also published normative values for the supine position obtained with the same equipment.…”

Section: Introductionmentioning

confidence: 99%

How the Body Position Can Influence High-resolution Manometry Results in the Study of Esophageal Dysphagia and Gastroesophageal Reflux Disease

Ciriza-de-los-Ríos

Rodríguez-Valcárcel

Lora-Pablos

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsThe body position can influence esophageal motility data obtained with high-resolution manometry (HRM). To examine whether the body position influences HRM diagnoses in patients with esophageal dysphagia and gastroesophageal reflux disease (GERD).Methods HRM (Manoscan) was performed in 99 patients in the sitting and supine positions; 49 had dysphagia and 50 had GERD assessed by 24-hour pH monitoring. HRM plots were analyzed according to the Chicago classification. ResultsHRM results varied in the final diagnoses of the esophageal body (EB) in patients with dysphagia (P = 0.024), the result being more distal spasm and weak peristalsis while sitting. In patients with GERD, the HRM diagnoses of the lower esophageal sphincter (LES), the esophagogastric junction (EGJ) morphology, and EB varied depending on the position; (P = 0.063, P = 0.017, P = 0.041 respectively). Hypotensive LES, EGJ type III (hiatal hernia), and weak peristalsis were more frequently identified in the sitting position. The reliability (kappa) of the position influencing HRM diagnoses was similar in dysphagia and GERD ("LES diagnosis": dysphagia 0.32 [0.14-0

show abstract

“…These electrodes respond to alterations in conductivity based on the intraluminal environment, such as air, mucosa and bolus [99]. A highly conductive ionic bolus (e.g., saline) has low resistance to the current flow and can be easily mapped to investigate bolus transfer and any post-swallow residual [76]. Thus, inferences can be made about the relationship between bolus transit observed with impedance and pressure derived from manometry [98].…”

Section: Impedance Manometrymentioning

confidence: 99%

“…This inherently improves the reliability of catheter placement, as the uppermost sensor can be positioned immediately inside the naris in all participants and the length of the upper aerodigestive tract can be evaluated in its entirety. Robust spatial resolution paired with the high temporal resolution has increased the popularity of pharyngeal HRM in research [76,77,78,79,80]. …”

Section: Pharyngeal Manometrymentioning

confidence: 99%

Expanding Instrumental Options for Dysphagia Diagnosis and Research: Ultrasound and Manometry

Huckabee

Macrae²,

Lamvik³

2015

Folia Phoniatr Logop

View full text Add to dashboard Cite

Diagnostic assessment of swallowing in routine clinical practice relies heavily on the long-standing techniques of videofluoroscopic swallowing study (VFSS) and videoendoscopic evaluation of swallowing (VEES). These complementary and sophisticated techniques provide a real-time visualization of biomechanical movements of the structures involved in swallowing and consequent effects on bolus flow. Despite the sophistication of this instrumentation, interpretation relies heavily on subjective clinical judgement and temporal resolution is limited, limitations that may influence patient management. Adjunctive diagnostic assessments may be utilized to compensate for the limitations posed by VFSS and VEES. Ultrasound and pharyngeal manometry do not represent the latest in technological advances, with both emerging in swallowing research over 20 years ago. However, both have resisted integration into routine clinical practice, despite the fact that they offer quantitative metrics of swallowing that are not available using standard techniques. The aim of this review is to present recent research on these two less frequently used modalities in clinical swallowing assessment, discuss potential applications in clinical practice and review supportive data on test-retest reliability, rater reliability and validity. The paper will conclude with a case report that exemplifies the unique contribution of these modalities in executing and revising therapeutic approaches for a patient with neurogenic dysphagia.

show abstract

New technologies in the gastrointestinal clinic and research: Impedance and high-resolution manometry

Cited by 42 publications

References 33 publications

Comparison of High-resolution Anorectal Manometry With Water-perfused Anorectal Manometry

Comparison of High-resolution Anorectal Manometry With Water-perfused Anorectal Manometry

How the Body Position Can Influence High-resolution Manometry Results in the Study of Esophageal Dysphagia and Gastroesophageal Reflux Disease

Expanding Instrumental Options for Dysphagia Diagnosis and Research: Ultrasound and Manometry

Contact Info

Product

Resources

About