Impaired deglutitive EGJ relaxation in clinical esophageal manometry: a quantitative analysis of 400 patients and 75 controls.

  title={Impaired deglutitive EGJ relaxation in clinical esophageal manometry: a quantitative analysis of 400 patients and 75 controls.},
  author={Sudip Kumar Ghosh and John E. Pandolfino and John Rice and John O. Clarke and Monika A. Kwiatek and Peter J. Kahrilas},
  journal={American journal of physiology. Gastrointestinal and liver physiology},
  volume={293 4},
Assessing deglutitive esophagogastric junction (EGJ) relaxation is an essential focus of clinical manometry. Our aim was to apply automated algorithmic analyses to high-resolution manometry (HRM) studies to ascertain the optimal method for discriminating normal from abnormal deglutitive EGJ relaxation. All 473 subjects (73 controls) were studied with a 36-channel solid-state HRM assembly during water swallows. Patients were classified as: 1) achalasia, 2) postfundoplication, 3) nonachalasia… 

Effects of Age on Esophageal Motility: A High-Resolution Manometry Study

IRP, DCI, and to a lesser extent, DL, are significantly correlated with the normal aging process in symptomatic patients and should be taken into consideration when interpreting esophageal HRM.

High-Resolution Impedance Manometry Metrics of the Esophagogastric Junction for the Assessment of Treatment Response in Achalasia

BFT, a novel HRIM metric, provided an improved functional assessment over manometric measures of EGJP, IRP, and EGJ-CI at follow-up after achalasia treatment and may help direct clinical management.

Has high-resolution manometry changed the approach to esophageal motility disorders?

Improved, accurate and reproducible recognition of manometric diagnoses by HRM will allow the clinician to confidently diagnose esophageal disorders such as achalasia, direct therapy and predict outcomes.

Evaluation of the Esophagogastric Junction on High Resolution Manometry.

Although current HRM metrics and maneuvers show promise in identifying clinically relevant EGJ abnormalities, future investigations evaluating management outcomes will improve segregation of normal from abnormal EGJ morphology and function.

Impaired bolus clearance in combined high-resolution esophageal manometry and impedance measurement helps to differentiate between esophagogastric junction outflow obstruction and achalasia.

A significant difference in impedance measurements between EGJOO and achalasia cases is demonstrated, demonstrating the role of the combined impedance-HRM investigation for early diagnosis of a Chalasia in "pre-achalasia" condition or in evaluation of potential progress of EGJoo to achalAsia should be evaluated in a prospective study.

Systematic analysis of esophageal pressure topography in high-resolution manometry of 68 normal volunteers.

Overall, the findings where strikingly similar to the previously described metrics derived from 75 control subjects of the Northwestern group, which suggests a high degree of reproducibility of HRM.

High-Resolution Manometry in Diagnosis and Treatment of Achalasia: Help or Hype

  • J. Richter
  • Medicine
    Current Gastroenterology Reports
  • 2014
High-resolution manometry with 36 pressure transducers spanning the esophagus has revolutionized the diagnosis and treatment of esophageal motility disorders, especially with respect to achalasia and recent studies suggest that HRM is superior to conventional manometry for diagnosis.

Clinical usefulness of esophageal high resolution manometry and adjunctive tests: An update.

  • C. GyawaliR. Penagini
  • Medicine
    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • 2021

Achalasia subtypes are front and center of the Chicago classification—strategies to overcome limitations in clinical application

High-resolution manometry (HRM) with closely spaced pressure sensors, enhances visualization and interpretation of esophageal pressures, and identifies three achalasia subtypes, through the Chicago classification of motility disorders.

Interrogation of esophagogastric junction barrier function using the esophagogastric junction contractile integral: an observational cohort study.

EGJ-CI is a novel HRM metric that has potential to complement or replace currently used basal LES and EGJ parameters and is evaluated in predicting esophageal acid exposure time (AET) and symptomatic outcome in this observational cohort study.



Quantifying EGJ morphology and relaxation with high-resolution manometry: a study of 75 asymptomatic volunteers.

HRM provides a seamless dynamic representation of pressure within and across the EGJ, and in addition to providing conventional EGJ relaxation parameters, this technology also creates opportunities to quantify more precise measures ofEGJ relaxation and morphology.

Quantifying esophageal peristalsis with high-resolution manometry: a study of 75 asymptomatic volunteers.

A detailed analysis of esophageal peristalsis was performed aimed at quantifying its essential features and new paradigms for the quantification of peristaltic function were devised that will hopefully optimize the utility of HRM in clinical and investigative studies.

Manometric heterogeneity in patients with idiopathic achalasia.

Critically evaluating the manometric criteria in a population of patients with idiopathic achalasia identified four manometrically distinct variants, which provide important clues into the pathophysiology of this rare disorder.

Detection of incomplete lower esophageal sphincter relaxation with conventional point-pressure sensors

Analyses that average postdeglutitive pressures are superior to isolated nadir values in correctly discerning incomplete lower sphincter relaxation suggest the transsphincteric gradient is a novel approach for measuring spharker relaxation, is unaffected by spHincter asymmetry and axial movement, and has the best receiver operating characteristics using point-pressure sensors.

Esophageal manometry: assessment of interpreter consistency.

  • D. NayarF. Khandwala M. Vaezi
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2005

Application of topographical methods to clinical esophageal manometry

Topographical methods are more accurate than commonly used methods in diagnosing the type of severe motor dysfunction and provide additional information important in the clinical practice of esophageal manometry.

Components of the standard oesophageal manometry

This document originates from several working groups attempting to standardize the performance and interpretation of oesophageal manometry. The authors present an interpretation of the consensus that

Classification of oesophageal motility abnormalities

Clinicians and researchers can determine if their patients fulfil the manometric criteria for a putative motility disorder by applying the guidelines proposed in this report, which should facilitate and improve comparisons among patients and studies.

High‐resolution manometry predicts the success of oesophageal bolus transport and identifies clinically important abnormalities not detected by conventional manometry

  • M. FoxG. Hebbard W. Schwizer
  • Medicine
    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
  • 2004
The accuracy with which bolus transport could be predicted from conventional manometry and high‐resolution manometry was compared to that from HRM in patients with endoscopy‐negative dysphagia in whom conventional investigations had been non‐diagnostic.

Comparison of pseudoachalasia and achalasia.