Technique of Functional and Motility Test: How to Perform Antroduodenal Manometry

Patcharatrakul, Tanisa; Gonlachanvit, Sutep

doi:10.5056/jnm.2013.19.3.395

Cited by 46 publications

(62 citation statements)

References 54 publications

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“…It has been hypothesized that severe mucosal damage and inflammation may be more strictly related to gastrointestinal motility derangement in CD [11]. However, this is discordant with the clinical situation, where CD can present with dyspeptic symptoms without signs or symptoms of severe inflammation [13]. …”

Section: Possible Mechanisms Involved In Motility Alterations In CD Amentioning

confidence: 86%

“…This constitutes a valuable method to assess gastroduodenal motility, and consists of the measurement of motor activity by the insertion of a manometric PVC catheter just beyond the angle of Treitz [13]. Intraluminal pressures are recorded using high-resolution solid-state transducers or water-perfused systems.…”

Section: Brief Overview Of Methods To Assess Gut Motilitymentioning

confidence: 99%

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Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

Sánchez

Berčík²,

Verdú³

2015

Dig Dis

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Regulation of gut motility is complex and involves neuromuscular, immune and environmental mechanisms. It is well established that patients with celiac disease (CD) often display gut dysmotility. Studies have shown the presence of disturbed esophageal motility, altered gastric emptying, and dysmotility of the small intestine, gallbladder and colon in untreated CD. Most of these motor abnormalities resolve after a strict gluten-free diet, suggesting that mechanisms related to the inflammatory condition and disease process are responsible for the motor dysfunction. Motility abnormalities are also a hallmark of functional bowel disorders such as irritable bowel syndrome (IBS), where it has been proposed as underlying mechanism for symptom generation (diarrhea, constipation, bloating). Non-celiac gluten sensitivity (NCGS) is a poorly defined entity, mostly self-diagnosed, that presents clinically with IBS symptoms in the absence of specific celiac markers. Patients with NCGS are believed to react symptomatically to wheat components, and some studies have proposed the presence of low-grade inflammation in these patients. There is little information regarding the functional characterization of these patients before and after a gluten-free diet. A study suggested the presence of altered gastrointestinal transit in NCGS patients who also have a high prevalence of nonspecific anti-gliadin antibodies. Results of an ongoing clinical study in NCGS patients with positive anti-gliadin antibodies before and after a gluten-free diet will be discussed. Elucidating the mechanisms for symptom generation in NCGS patients is important to find new therapeutic alternatives to the burden of imposing a strict gluten-free diet in patients who do not have CD.

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Section: Possible Mechanisms Involved In Motility Alterations In CD Amentioning

confidence: 86%

Section: Brief Overview Of Methods To Assess Gut Motilitymentioning

confidence: 99%

Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

Sánchez

Berčík²,

Verdú³

2015

Dig Dis

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“…Using antroduodenal manometry (ADM), other groups have demonstrated the use of duodenal motility patterns to make diagnoses that could not be made empirically from the clinical history alone (19). To date, the link between symptom severity and physiologic abnormalities in gastroparesis has proven elusive, with poor correlation continually observed between symptoms and gastric transit and pressure parameters (15–17).…”

Section: Discussionmentioning

confidence: 99%

Duodenal rather than antral motility contractile parameters correlate with symptom severity in gastroparesis patients

Barshop

Staller

Semler

et al. 2014

Neurogastroenterology Motil

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Background Studies of symptomatic gastroparetics consistently find poor correlation with gastric emptying. We hypothesized that concomitant small bowel dysmotility may play a role in symptom causation in gastroparesis and sought to test this hypothesis by using wireless motility capsule (WMC) testing to simultaneously measure antral and duodenal area under pressure curve (AUC) in patients with delayed gastric emptying. Methods Using a cohort from a multicenter clinical trial and a separate tertiary clinical database, we identified gastroparetics that underwent concurrent WMC testing and completed the Gastroparesis Cardinal Symptom Index, a validated questionnaire. Our study included 35 gastroparetics defined by a Gastric Emptying Time (GET) >5 hrs. Antral and duodenal AUC were assessed at 1-hour windows pre-GET and post-GET, respectively. Key Results We found moderate correlations between duodenal AUC and symptom severity in the combined cohort (n=35; R=−0.42; p=0.01; 95% CI −0.7, −0.1). Removing patients with colonic delay resulted in a stronger correlation of duodenal AUC to symptom severity (n=21; R=−0.63; p<0.01; 95% CI −0.81, −0.31). The multicenter trial (n=20) and clinical practice cohorts (n=15) had significantly-different symptom severity and exclusion criteria. When analyzed separately, significant correlations between duodenal AUC and symptom severity were observed (R=−0.71; p<0.01; 95% CI −0.9, −0.4 and R=−0.72; p<0.01; 95% CI −0.9, −0.3, respectively). Symptom severity and antral motility showed no correlation. Conclusions & Inferences We found significant correlations between duodenal AUC and symptom severity in two cohorts of gastroparetics. Small bowel motility may contribute to symptom generation in gastroparetic patients and this may inform therapeutic considerations.

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“…The recent advent of solidstate high-resolution ADM catheters may address some of these difficulties in future. 29 WGS can be used to estimate SBTT and this technique has been compared to WMC in a small study of 10 subjects, in which the two procedures were concurrently undertaken. 30,31 It was shown that WMC measured small bowel contractions per min showed a positive correlation with percentage scintigraphic small bowel transit (r ¼ 0.69; p ¼ 0.05).…”

Section: Stomachmentioning

confidence: 99%

Gastrointestinal motility revisited: The wireless motility capsule

2013

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Introduction: The wireless motility capsule (WMC) is a novel ambulatory technology that concurrently measures intraluminal pH, temperature, and pressure as it traverses the gastrointestinal tract. Objectives: We aim to provide a concise summary of the WMC, detailing the procedure for its administration and the parameters it records. We also review the evidence that has validated the WMC against other methods currently regarded as 'gold standard'. Conclusions: The WMC offers a number of advantages over and above current techniques, especially with respect to patient tolerability, safety, and standardization. The WMC represents a considerable enhancement of the researchers' and clinicians' investigatory armamentarium. If this technology becomes widely adopted, coupled with international consensus upon the interpretation of physiological data derived therein, it may herald a new and exciting era in gastrointestinal physiology.

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Technique of Functional and Motility Test: How to Perform Antroduodenal Manometry

Cited by 46 publications

References 54 publications

Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

Duodenal rather than antral motility contractile parameters correlate with symptom severity in gastroparesis patients

Gastrointestinal motility revisited: The wireless motility capsule

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