A Rapid Pull-Through Technique for Measuring Lower Esophageal Sphincter Pressure

Dodds, Wylie J.; Hogan, Walter J.; Stef, John J.; Miller, William N.; Lydon, Sean B.; Arndorfer, Ronald C.

doi:10.1016/s0016-5085(75)80079-5

Cited by 124 publications

(20 citation statements)

References 14 publications

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“…18 Interobserver variation has also been assessed in the evaluation of pull through techniques for the measurement of lower oesophageal sphincter pressure. 19,20 Interlaboratory differences have been noted in the analysis of ADM with respect to the identification of Ôlate phase IIIÕ of the MMC. 21 However, few studies have set out with the primary aim of assessing interobserver variability in the assessment of manometric data.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory bowel disease 36 Histological diagnosis of inflammatory bowel disease K = 0.47 Normal K = 0.43 Inflammatory bowel disease K = 0.2 CrohnÕs disease K = 0. 19 Non-specific inflammation Inflammatory bowel disease 37 Histological diagnosis of inflammatory bowel disease K = 0.43 Normal K = 0.37…”

Section: Discussionmentioning

confidence: 99%

“…Ulcerative colitis K = 0.2 CrohnÕs disease K = 0. 19 Non-specific Jaundiced patients 38 Physical examination of jaundiced patients Presence of physical signs K = 0.32 Spleen palpable K = 0. 26 Character of liver edge Necrotizing enterocolitis 39 Presence of necrotizing enterocolitis on abdominal radiographs K = 0.31…”

Section: Discussionmentioning

confidence: 99%

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Interobserver variability in antroduodenal manometry

Connor

Hyman

Fauré

et al. 2009

Neurogastroenterology Motil

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Interobserver variability affects investigations involving assessment of complex visual data, such as histopathology, radiology and motility. This study assessed interobserver variation for interpretation of antroduodenal manometry (ADM), as this has not been previously investigated. Thirty-five ADM recordings from children aged 0.3-18 years were independently evaluated by five experienced paediatric gastroenterologists who were blinded to cases' clinical histories. Intra-class correlation (ICC) was analysed for detection and measurement of phase three of the migrating motor complex (MMC) and Cohen's kappa statistic was calculated between observer pairs for detection of specific motility features and final diagnosis. Observers were unanimous on the differentiation of normal and abnormal motility in 63% of cases. There was excellent interobserver agreement for the number of phase three of the MMC in fasting (ICC = 0.82, P < 0.0001) and for measurements of phase three of the MMC (ICC = 0.9999, P < 0.0001). Detection of other normal and abnormal motility patterns varied more. Objective findings such as the presence of phase three of the MMC correlated more closely than findings that involved the integration of several variables, such as final diagnosis. However, these data overall indicate that agreement between expert observers for the distinction of normal and abnormal antroduodenal motility compares favourably with other standard medical assessments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Interobserver variability in antroduodenal manometry

Connor

Hyman

Fauré

et al. 2009

Neurogastroenterology Motil

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“…Evaluation of esophageal dysfunction. The methods we used have been described in detail previously (30)(31)(32). In summary, patients were evaluated in the fasting state and in a supine position, using a triple-lumen assembly (inside diameter of each lumen, 1.1 mm) with radially oriented side ports (diameter, 1 mm) spaced 5 cm apart.…”

Section: Methodsmentioning

confidence: 99%

“…For manometry, the catheter assembly was passed via the mouth. The LESP was recorded by the conventional station pull-through technique and by a rapid pull-through technique (31). The station pull-through technique consisted of withdrawal of the radial recording tips through the LES in 0.5-cm increments, with a pause of 20 seconds or longer at each station; we assessed resting LESP by measuring peak LESP at the pressure inversion point.…”

Section: Methodsmentioning

confidence: 99%

Nifedipine and esophageal dysfunction in progressive systemic sclerosis. A controlled manometric study

Kahan¹,

Bour²,

Couturier³

et al. 1985

Arthritis & Rheumatism

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We evaluated the effect of the calcium channel blocking agent, nifedipine, on esophageal dysfunction in 15 patients with progressive systemic sclerosis, using a double-blind, randomized, crossover, placebo-controlled manometric study. Nifedipine significantly decreased lower esophageal sphincter pressure in these patients; this reduced lower esophageal sphincter pressure may cause gastroesophageal reflux. Thus, nifedipine may have detrimental effects on progressive systemic sclerosis patients.The pathogenesis of esophageal dysfunction in progressive systemic sclerosis (scleroderma; PSS) has not been well elucidated (1,2). PSS is characterized by vascular and microvascular abnormalities (1-4), excessive fibroblastic activity (5,6), and collagen deposition in numerous organs (1,2,7). The possibility that the lesions in target organs are a reflection of a primary fibrous tissue overgrowth leading to secondary vascular compromise has not been ruled out. Nevertheless, a growing body of evidence based on studies of several organs involved in PSS suggests that the vascular system per se may be the primary target organ and that the lesions are a manifestation of focal ischemic injury resulting from functional, with or without accompanying structural, vascular disease (~4 , 8 4 4 ) .Nifedipine, a calcium channel blocking agent, is effective in the treatment of coronary vasospasm ( I 5-18). We (19-21) and others (22)(23)(24)(25) have shown that nifedipine is effective in the treatment of idiopathic Raynaud's phenomenon and Raynaud's phenomenon occurring with progressive systemic sclerosis. Thus, if a microvascular abnormality is a contributor to the pathogenesis of scleroderma, nifedipine may be useful in the treatment of patients with early disease.However, nifedipine may have detrimental effects caused by its direct action on the lower esophageal sphincter. The actions of nifedipine on smooth muscle cells are well documented (15)(16)(17)(18). Several studies have shown that the drug decreases the lower esophageal sphincter pressure (LESP) in patients with achalasia (26,27). If nifedipine also decreases the LESP in patients with progressive systemic sclerosis, this could lead to gastroesophageal reflux.In the present investigation, we used a controlled, double-blind, randomized, crossover manometric study to evaluate the effect of nifedipine on I5 patients with progressive systemic sclerosis and esophageal dysfunction. Our trial demonstrates that nifedipine significantly decreases the lower esophageal sphincter pressure in patients with PSS. PATIENTS AND METHODSPatients. Fifteen patients with progressive systemic sclerosis and diffuse scleroderma were studied. All patients satisfied the American Rheumatism Association preliminary criteria for classification of definite systemic sclerosis (28). None of the patients had the CREST syndrome variant (calcinosis, Raynaud's phenomenon, esophageal dysmo-NIFEDIPINE IN PSS 49 1 tility, sclerodactyly, telangiectasias) of PSS (29). The presence of the esophageal symptoms of heartbur...

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Instrumentation and Methods for Intraluminal Esophageal Manometry

Dodds¹

1976

Arch Intern Med

137

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A Rapid Pull-Through Technique for Measuring Lower Esophageal Sphincter Pressure

Cited by 124 publications

References 14 publications

Interobserver variability in antroduodenal manometry

Interobserver variability in antroduodenal manometry

Nifedipine and esophageal dysfunction in progressive systemic sclerosis. A controlled manometric study

Instrumentation and Methods for Intraluminal Esophageal Manometry

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