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

@article{Pandolfino2006QuantifyingEM,
  title={Quantifying EGJ morphology and relaxation with high-resolution manometry: a study of 75 asymptomatic volunteers.},
  author={John E. Pandolfino and Sudip Kumar Ghosh and Qing Zhang and Andrew Jarosz and Nimeesh K. Shah and Peter J. Kahrilas},
  journal={American journal of physiology. Gastrointestinal and liver physiology},
  year={2006},
  volume={290 5},
  pages={
          G1033-40
        }
}
Our aim was to define normal esophagogastric junction (EGJ) morphology and relaxation characteristics using high-resolution manometry (HRM). To this end, 75 asymptomatic controls underwent HRM with a solid-state manometric assembly incorporating 36 circumferential sensors spaced at 1-cm intervals positioned to record from the hypopharynx to the stomach. Ten 5-ml water swallows were obtained. EGJ relaxation was quantified by 1) nadir pressure, 2) the lowest 3-s mean residual pressure after… 

Figures and Tables from this paper

Deglutitive upper esophageal sphincter relaxation: a study of 75 volunteer subjects using solid-state high-resolution manometry.

The enhanced spatial resolution of HRM allows for the accurate, automated assessment of UES relaxation and intrabolus pressure characteristics, in both cases confirming the volume-dependent effects and absolute values of these parameters previously demonstrated by detailed analysis of concurrent manometry/fluoroscopy data.

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

It is expected that applying rigorous methodology such as described herein to the analysis of HRM studies will improve the consistency in the interpretation of clinical manometry and prove useful in guiding clinical management.

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.

High-resolution Manometry can Characterize Esophagogastric Junction Morphology and Predict Esophageal Reflux Burden

Conventional LES and EGJ metrics were also associated with abnormal reflux burden, but intra-abdominal LES length, and hiatus hernia size did not independently predict total AET.

High-Resolution Manometry in the Evaluation of Anorectal Disorders: A Simultaneous Comparison With Water-Perfused Manometry

Simultaneously recorded resting, squeeze, and relaxation pressures showed the two methods to be significantly correlated although anal sphincter pressures recorded by HRM tended to be higher than those recorded with WPM although HRM provided greater resolution of the intraluminal pressure environment of the anorectum.

A High-resolution View of Achalasia

High-resolution manometry demonstrates alterations of esophageal motor function in achalasia that are not easily observed with other manometric techniques.

Integrated Relaxation Pressure During Swallowing: An Ever-changing Metric

  • E. Gong
  • Medicine
    Journal of neurogastroenterology and motility
  • 2021
This issue of the Journal of Neurogastroenterology and Motility, a study by Elangovan et al investigating the durability of the IRP during successive swallows in the supine position has been published.

The clinical usefulness of high-resolution manometry for the management of achalasia

  • M. Vela
  • Medicine
    Current gastroenterology reports
  • 2009
The usefulness of HRM in the management of achalasia is addressed, with studies clearly documenting the advantages of this technique over conventional manometry in the clinical setting have been lacking.

Endoscopic and manometric position-related characteristics of the normal gastroesophageal junction

In normal individuals, the GEV exhibits a temporary weakening when moved from LLD to upright position, however, the normal GEV is able to maintain LESP in upright position and in patients with early GERD, a greater degree of valve incompetence at the GEJ is seen.

Classifying Esophageal Motility by Pressure Topography Characteristics: A Study of 400 Patients and 75 Controls

A systematic approach to analyzing esophageal motility using HRM and pressure topography plots is developed, consistent with conventional classifications with the caveats that hypercontractile conditions are more specifically defined, distinctions are made between rapidly propagated contractions and compartmentalized esophagal pressurization, and there is no “nonspecific esphageal motor disorder” classification.
...

References

SHOWING 1-8 OF 8 REFERENCES

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.

Combined Multichannel Intraluminal Impedance and Manometry Clarifies Esophageal Function Abnormalities: Study in 350 Patients

Esophageal body pressures primarily determine bolus transit with isolated LES abnormalities appearing to have little effect on esophageaal function.

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

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.

Topography of the esophageal peristaltic pressure wave.

It is suggested that two neuromuscular contraction units can be detected in the distal smooth muscle esophagus and this technique should be useful in understanding altered relationships of these units under differing physiological conditions or with disease.

Intersubject and Interswallow Variability in Topography of Esophageal Motility

Topographic plotting of single swallows is feasible and the presence of sequential contraction segments in the esophagus is confirmed, helping demonstrate twosegments within the smooth-muscle body, an anatomical region of seeming homogeneity, that have sufficient contraction independence to indicate separateneuromuscular units responding to different contractileinfluences.

AJP-Gastrointest Liver Physiol @BULLET

  • AJP-Gastrointest Liver Physiol @BULLET

All values are expressed as means (SD) UESB, bottom of the upper esophageal sphincter; EGJT, top of the EGJ; EGJmax, maximal EGJ pressure; EGJB bottom of the EGJ

  • All values are expressed as means (SD) UESB, bottom of the upper esophageal sphincter; EGJT, top of the EGJ; EGJmax, maximal EGJ pressure; EGJB bottom of the EGJ