Advancements in the use of manometry and impedance testing for esophageal functional disorders

Savarino, Edoardo; Marabotto, Elisa; Bodini, Giorgia; Furnari, Manuele; Coletta, Marco; Ghisa, Matteo; Barberio, Brigida; Frazzoni, Marzio; Bortoli, Nicola de; Zentilin, Patrizia; Pellegatta, Gaia; Tolone, Salvatore; Ottonello, Andrea; Savarino, Vincenzo

doi:10.1080/17474124.2019.1595587

Cited by 13 publications

(23 citation statements)

References 87 publications

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“…After its introduction as a valid diagnostic tool for the assessment of motility disorders of the esophagus since the 1970s, this technique has been the object of many important technological advancements overtime that have progressively improved our ability to study and understand esophageal motility dysfunctions and related morbidities, 8 including SSc (Table 1).…”

Section: Features Assessed Convention Manometry High‐resolution (Impe...mentioning

confidence: 99%

“…This technique is based on catheters with smaller spacings between side‐holes than those of conventional manometry 5–8 . They are equipped with intraluminal solid‐state pressure transducers that directly interface with the recorder and the resultant system has a vastly expanded frequency response suitable also for pharyngeal recording.…”

Section: Data From High‐resolution Manometry (Hrm) In Systemic Sclerosismentioning

confidence: 99%

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Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis

Marabotto

Savarino

2022

Neurogastroenterology Motil

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Systemic sclerosis (SSc) is a chronic and generalized disease affecting the connective tissue of the skin and many internal organs, in particular the gastrointestinal tract.The esophagus is involved in up to 80% of the cases and represents a major cause of serious morbidities that deeply impact on the quality of life and survival of patients.How to cite this article: Marabotto E, Savarino V, Savarino E.Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis.

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Section: Features Assessed Convention Manometry High‐resolution (Impe...mentioning

confidence: 99%

Section: Data From High‐resolution Manometry (Hrm) In Systemic Sclerosismentioning

confidence: 99%

Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis

Marabotto

Savarino

2022

Neurogastroenterology Motil

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“…Unlike conventional manometry, high-resolution impedance manometry (HRIM) measures esophageal pressures with 423 sensors distributed longitudinally and radially in the esophagus, along with esophageal impedance monitoring (18 sensors), thus allowing for a very detailed evaluations of esophageal pressures, peristalsis, sphincter functions, and reflux [4]. It might, therefore, identify relevant abnormalities not detected by conventional manometry.…”

Section: Introductionmentioning

confidence: 99%

Characterization of esophageal motor activity, gastroesophageal reflux, and evaluation of prokinetic effectiveness in mechanically ventilated critically ill patients: a high-resolution impedance manometry study

et al. 2021

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Background Motility disorders of upper gastrointestinal tract are common in critical illness and associated with significant clinical consequences. However, detailed quantitative and qualitative analyses of esophageal motor functions are lacking. Therefore, we aimed to characterize the key features of esophageal motility functions using high-resolution impedance manometry (HRIM) and to evaluate an objective link between esophageal motor patterns, gastric emptying, and gastroesophageal reflux. We also studied the prokinetic effects of metoclopramide. Methods We prospectively performed HRIM for 16 critically ill hemodynamically stable patients. Patients were included if they had low gastric volume (LGV; < 100 mL/24 h, n = 8) or high gastric volume (HGV; > 500 mL/24 h, n = 8). The HRIM data were collected for 5 h with intravenous metoclopramide administration (10 mg) after the first 2 h. Results The findings were grossly abnormal for all critically ill patients. The esophageal contraction vigor was markedly increased, indicating prevailing hypercontractile esophagus. Ineffective propulsive force was observed for 73% of esophageal activities. Panesophageal pressurization was the most common pressurization pattern (64%). Gastroesophageal reflux predominantly occurred with transient lower esophageal sphincter relaxation. The common features of the LGV group were a hyperreactive pattern, esophagogastric outflow obstruction, and frequent reflux. Ineffective motility with reduced lower esophageal sphincter tone, and paradoxically fewer reflux episodes, was common in the HGV group. Metoclopramide administration reduced the number of esophageal activities but did not affect the number of reflux episodes in either group. Conclusion All critically ill patients had major esophageal motility abnormalities, and motility patterns varied according to gastric emptying status. Well-preserved gastric emptying and maintained esophagogastric barrier functions did not eliminate reflux. Metoclopramide failed to reduce the number of reflux episodes regardless of gastric emptying status. Trial registration ISRCTN, ISRCTN14399966. Registered 3.9.2020, retrospectively registered. https://www.isrctn.com/ISRCTN14399966.

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“…Esophageal manometry is indicated in patients with dysphagia and is considered the gold standard for the diagnosis of achalasia. 1 Esophageal high-resolution manometry (HRM) enables the comprehensive evaluation of esophageal motor function. 2 , 3 Although the Chicago classification for esophageal motor disorders is widely accepted as a standard, the detailed measurement protocols are not uniform and vary according to centers and physicians.…”

Section: Introductionmentioning

confidence: 99%

Variations in Clinical Practice of Esophageal High-resolution Manometry: A Nationwide Survey

Gong

Choi

Lee

et al. 2021

J Neurogastroenterol Motil

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Background/AimsEsophageal high-resolution manometry (HRM) enables the comprehensive evaluation of the esophageal motor function. However, protocols are not uniform and clinical practices vary widely among institutions. This study aims to understand the current HRM practice in Korea. MethodsThe survey was sent via email through the Korean Society of Neurogastroenterology and Motility. The questions covered descriptive information, preparation, techniques, analysis, and reporting of esophageal HRM. ResultsThe survey was completed in 32 (74.4%) out of 43 centers, including 24 tertiary and 8 secondary referral centers. Of the 32 centers, 25 (78.1%) performed HRM in a sitting position, while 7 centers (21.9%) reported performing HRM in a supine position. All the centers utilized single wet swallows as a standard, but the volume, frequency, and interval between swallows varied widely. Sixteen centers (50.0%) applied adjunctive tests, including multiple rapid swallows (n = 16) and rapid drink challenges (n = 9). Parameters assessed and documented in the report were similar. In addition to the assessment of the esophagogastric junction and esophageal body, 27 centers (84.8%) and 18 centers (56.3%) included measurements for the upper esophageal sphincter and the pharynx, respectively, in the HRM protocol. ConclusionsWe found a variation in the available HRM practice among centers, even though they broadly agreed in the data analysis. Efforts are needed to develop a standardized protocol for HRM measurement.

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Advancements in the use of manometry and impedance testing for esophageal functional disorders

Cited by 13 publications

References 87 publications

Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis

Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis

Characterization of esophageal motor activity, gastroesophageal reflux, and evaluation of prokinetic effectiveness in mechanically ventilated critically ill patients: a high-resolution impedance manometry study

Variations in Clinical Practice of Esophageal High-resolution Manometry: A Nationwide Survey

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