Normal values for solid‐state esophageal high‐resolution manometry in a <scp>E</scp>uropean population; an overview of all current metrics

Weijenborg, Pim W.; Kessing, Boudewijn F.; Smout, Andreas J.; Bredenoord, Albert J.

doi:10.1111/nmo.12314

Cited by 88 publications

(107 citation statements)

References 21 publications

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“…Intrabolus pressures (IBP) and the 0.25 second integrated relaxation pressure (IRP) [30] were similar between volumes at the level of the UES. However, at 1cm above the UES, IBP increased across volumes ( Figure 3B; F = 4.27, P = 0.02) and particularly increased at 20ml.…”

Section: Pressure Flow Measurementsmentioning

confidence: 93%

Modulation of Upper Esophageal Sphincter (UES) Relaxation and Opening During Volume Swallowing

et al. 2016

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Background: UES opening occurs following cricopharyngeus deactivation and submental muscle contraction causing hyolaryngeal elevation and UES distraction. During impedance manometry, the inverse of impedance (admittance) can be used to measure bolus presence and infer UES opening. We hypothesized that the temporal relationship between UES relaxation, opening and hyolaryngeal elevation would change with increasing bolus volume. Methods: Simultaneous intramuscular cricopharyngeal (CP) electromyography (EMG), surface submental EMG (SM-EMG) and high-resolution impedance manometry (HRIM)were recorded in eight (aged 27±7 yrs, 5M) healthy volunteers while swallowing 0.9% Saline boluses of 2,5,10 and 20ml. Data were exported and analyzed via Matlab. Statistical analysis comprised of repeated measured one-way ANOVA and Pearson correlation. A P-value of < 0.05 was considered significant Results: Duration of CP deactivation increased at 20ml volume (P < 0.001). UES relaxation and opening increased with increasing bolus volume (P < 0.001), however overall duration of SM activation did not change. As UES opening occurs progressively earlier with increasing volumes, peak SM-EMG activity occurs relatively later (P < 0.001) and shifts from occurring before to following peak UES distention. Conclusions

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Section: Pressure Flow Measurementsmentioning

confidence: 93%

Modulation of Upper Esophageal Sphincter (UES) Relaxation and Opening During Volume Swallowing

et al. 2016

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“…Three discrete hypopharyngeal IBPs (IBP1, IBP2, and IBP3) were measured: 1 cm proximal to the UES apogee position and temporally aligned to maximum admittance (maximum distension) at the hypopharynx (IBP1), maximum admittance at the UES apogee (IBP2), and maximum admittance 1 cm below the UES apogee (IBP3). The e-sleeve method, based on maximum axial UES pressures (as described above), was used to measure the UES residual pressure and the UES 0.25-s integrated relaxation pressure, which is the median of all the lowest UES pressures (contiguous or noncontiguous) measured over a 0.25-s period (32). The maximum luminal cross-sectional area during bolus flow was inferred on the basis of maximum admittance at the hypopharynx, the UES apogee, and 1 cm below the UES apogee (23).…”

Section: Methodsmentioning

confidence: 99%

Remifentanil alters sensory neuromodulation of swallowing in healthy volunteers: quantification by a novel pressure-impedance analysis

Doeltgen

Omari

Savilampi

2016

American Journal of Physiology-Gastrointestinal and Liver Physi

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Exposure to remifentanil contributes to an increased risk of pulmonary aspiration, likely through reduced pharyngeal contractile vigor and diminished bolus propulsion during swallowing. We employed a novel high-resolution pressure-flow analysis to quantify the biomechanical changes across the upper esophageal sphincter (UES). Eleven healthy young (23.3 ± 3.1 yr old) participants (7 men and 4 women) received remifentanil via intravenous target-controlled infusion with an effect-site concentration of 3 ng/ml. Before and 30 min following commencement of remifentanil administration, participants performed ten 10-ml saline swallows while pharyngoesophageal manometry and electrical impedance data were recorded using a 4.2-mm-diameter catheter housing 36 circumferential pressure sensors. Remifentanil significantly shortened the duration of UES opening (P < 0.001) and increased residual UES pressure (P = 0.003). At the level of the hypopharynx, remifentanil significantly shortened the latency from maximum bolus distension to peak contraction (P = 0.004) and significantly increased intrabolus distension pressure (P = 0.024). Novel mechanical states analysis revealed that the latencies between the different phases of the stereotypical UES relaxation sequence were shortened by remifentanil. Reduced duration of bolus flow during shortened UES opening, in concert with increased hypopharyngeal distension pressures, is mechanically consistent with increased flow resistance due to a more rapid bolus flow rate. These biomechanical changes are congruent with modification of the physiological neuroregulatory mechanism governing accommodation to bolus volume.

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“…These values have shown both similarities and discrepancies as compared to the ones published by the Chicago group. 11 However, the normal eating position is upright and dysphagia by definition occurs while eating. Different methods have been applied in clinical esophageal manometry testing.…”

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

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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

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Normal values for solid‐state esophageal high‐resolution manometry in a European population; an overview of all current metrics

Cited by 88 publications

References 21 publications

Modulation of Upper Esophageal Sphincter (UES) Relaxation and Opening During Volume Swallowing

Modulation of Upper Esophageal Sphincter (UES) Relaxation and Opening During Volume Swallowing

Remifentanil alters sensory neuromodulation of swallowing in healthy volunteers: quantification by a novel pressure-impedance analysis

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

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