Normative values in esophageal high‐resolution manometry

Herregods, T. V. K.; Roman, Sabine; Kahrilas, Peter J.; Smout, A. J. P. M.; Bredenoord, Albert J.

doi:10.1111/nmo.12500

Cited by 82 publications

(107 citation statements)

References 47 publications

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“…The device utilized in the investigational work for the development of the CC was the apparatus designed by Sierra Scientific ( currently marketed by Medtronic, UK). Hence, the published normal values and discriminant characteristics of these metrics pertain to studies using Sierra devices and are different for studies using other equipment 12 . This consideration is especially relevant with respect to measuring the completeness of oesophagogastric junction (EGJ) relaxation, key to the diagnosis of achalasia.…”

Section: Analysis Metrics Utilized In the CCmentioning

confidence: 99%

Advances in the management of oesophageal motility disorders in the era of high-resolution manometry: a focus on achalasia syndromes

Kahrilas

Bredenoord

Fox

et al. 2017

Nat Rev Gastroenterol Hepatol

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High-resolution manometry (HRM), along with the analysis algorithms characterized in the Chicago Classification (CC) first proposed in 2008, have led to a major restructuring of the classification of oesophageal motility disorders. The inherently quantitative output of HRM devices fuelled enthusiastic expectation among motility experts that these advances would add a level of precision to the diagnosis of oesophageal motility disorders that was not previously possible. Nowhere was this advance more evident than in our concept of achalasia, now differentiated into subtypes as a direct result of HRM. Coincident with the assimilation of HRM into clinical practice was the development of a major therapeutic intervention for the management of oesophageal motility disorders, per-oral endoscopic myotomy (POEM). Not only does the POEM procedure provide a therapeutic option for myotomy with reduced morbidity relative to laparoscopic or open myotomy, but it also enables a calibrated intervention that is customized to patient-specific physiology. Together, these develop ments fostered an increasing emphasis on targeting therapy to specific aspects of oesophageal dysfunction, as measured by physiological testing, rather than discrete diagnoses. Again, nowhere is this evolution more evident than in our strategies for managing achalasia. This Consensus Statement examines the effect of HRM on our current understanding of oesophageal motility disorders with a focus on how this technology has affected the diagnosis, epidemiology and management of achalasia and achalasia-like syndromes. on behalf of the International Working Group for Disorders of Gastrointestinal Motility and FunctionAbstract | High-resolution manometry (HRM) and new analysis algorithms, summarized in the Chicago Classification, have led to a restructured classification of oesophageal motility disorders. This advance has led to increased detection of clinically relevant disorders, in particular achalasia. It has become apparent that the cardinal feature of achalasia -impaired lower oesophageal sphincter (LES) relaxation -can occur in several disease phenotypes: without peristalsis (type I), with pan-oesophageal pressurization (type II), with premature (spastic) distal oesophageal contractions (type III), or with preserved peristalsis (outlet obstruction). Furthermore, no manometric pattern is perfectly sensitive or specific for achalasia caused by a myenteric plexopathy, and there is no biomarker for this pathology. Consequently, physiological testing reveals other syndromes not meeting achalasia criteria that also benefit from therapies formerly reserved for achalasia. These findings have become particularly relevant with the development of a minimally invasive technique for performing a long oesophageal myotomy, the per-oral endoscopic myotomy (POEM). Optimal management is to render treatment in a phenotype-specific manner; that is, POEM calibrated to patient-specific physiology for spastic achalasia and the spastic disorders, and more conservative strategies...

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Section: Analysis Metrics Utilized In the CCmentioning

confidence: 99%

Advances in the management of oesophageal motility disorders in the era of high-resolution manometry: a focus on achalasia syndromes

Kahrilas

Bredenoord

Fox

et al. 2017

Nat Rev Gastroenterol Hepatol

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“…In the sitting position the proportion of abnormal contractions increase (2,10,12) , the distal contraction integral and the amplitude of contractions decrease (4,6,11,12) . It could be, at least in part, the explanation for the absence of difference between men and women.…”

Section: Discussionmentioning

confidence: 98%

“…HRM is a modern method for esophageal motility evaluation, however the examination performed in different countries did not found the same results (4) . The type of HRM system, catheter diameter, demographic factors, body position during the test, consistency of the bolus swallowed and esophageal length have influence on the results of the examination (10) .…”

Section: Discussionmentioning

confidence: 99%

“…It represents the mean esophageal gastric transition pressure measured for four contiguous or non contiguous seconds of relaxation in the 10 seconds window following deglutitive upper esophageal sphincter relaxation (10) . An increase in IRP means an outflow obstruction at the esophageal gastric transition (13) .…”

Section: Discussionmentioning

confidence: 99%

“…Esophageal motility has the influence of body position (2,4,6,10,12) and the characteristics of the swallowed bolus (2,5,6,10) , and may also have the influence of gender.…”

Section: Introductionmentioning

confidence: 99%

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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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High‐Resolution Manometry and Esophageal Pressure Topography

Carlson

Kahrilas

2021

The Esophagus

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Normative values in esophageal high‐resolution manometry

Cited by 82 publications

References 47 publications

Advances in the management of oesophageal motility disorders in the era of high-resolution manometry: a focus on achalasia syndromes

Advances in the management of oesophageal motility disorders in the era of high-resolution manometry: a focus on achalasia syndromes

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

High‐Resolution Manometry and Esophageal Pressure Topography

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