Distal contractile to impedance integral ratio assist the diagnosis of pediatric ineffective esophageal motility disorder

Wu, Jiafeng; Chung, C.‐S.; Tseng, Ping‐Huei; Tsai, I-Jung; Lin, Yi‐Cheng; Yang, Chia-Hsiang

doi:10.1038/s41390-018-0197-3

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…The 24 h MII‐pH monitoring was approved to identify the phenotypes of GERD, but this is not sensitive in the diagnosis of esophageal motility disorder . Given that 24 h MII‐pH was not covered by the National Health Insurance of Taiwan before 2017, only four subjects (28.57%) in the IEM group received MII‐pH in the present study.…”

Section: Discussionmentioning

confidence: 99%

Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms

Hsing

Tsai

Hsu

et al. 2019

Pediatrics International

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Background: We investigated the prevalence of psychiatric referral, frequency of repeat upper gastrointestinal (UGI) contrast studies, and esophagogastroduodenoscopy (EGD) in children with ineffective esophageal motility (IEM) before the confirmation of esophageal dysmotility. Methods: A total of 19 children (nine boys, 10 girls; mean age, 13.80 AE 5.10 years) with symptoms of refractory gastroesophageal reflux (GER) who underwent high-resolution esophageal impedance manometry (HRIM) were enrolled in this retrospective analysis. Refractory GER symptoms were defined as persistent symptoms even under acid-suppression therapy for 8 weeks in this study. Clinical data including age, gender, time from symptom onset to diagnosis, and number of UGI contrast studies and EGD before diagnosis were obtained. HRM parameters and the prevalence of psychiatric referral were also analyzed. Results: There are 14 children (73.68%) diagnosed with IEM by HRIM, and another 5 children (26.32%) diagnosed as GER disease (GERD) by EGD. A significant proportion of IEM children were misdiagnosed with psychological problems compared with the GERD children (78.57% vs 20.00%, P = 0.04). Three IEM children (21.43%) received antipsychotic and antidepressant agents before diagnosis of IEM, and all of them discontinued these medications after diagnosis. IEM children underwent a greater number of UGI contrast studies (1.07 AE 0.92 vs 0.20 AE 0.45; P = 0.02) and EGD (2.36 AE 2.50 vs 0.60 AE 0.55; P = 0.03) before HRM than GERD children. Conclusions: Esophageal manometry for the diagnosis of IEM should be considered in children with GER symptoms refractory to acid-suppression therapy for 8 weeks to avoid repeat UGI contrast studies, EGD, and psychological therapy.

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Section: Discussionmentioning

confidence: 99%

Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms

Hsing

Tsai

Hsu

et al. 2019

Pediatrics International

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“…The DCI to esophageal impedance integral (DCIIR) ratio at an impedance cutoff of 1500 Ω can be used to diagnose patients with effective esophageal motility. A DCIIR of 1500 < 0.009 suggests ineffective esophageal motility 38 .…”

Section: Newer Biometrics For Esophageal Functionmentioning

confidence: 99%

High-resolution esophageal manometry in children

WAIKAR¹

2023

Clin Exp Pediatr

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Functional disorders of the esophagus are known as esophageal dysmotility disorders. Esophageal manometry can be used to study swallowing disorders, feeding problems, non-obstructive dysphagia, and lower esophageal dysfunction. This paper discusses the recent advances in and reviews the use of highresolution esophageal manometry in children. The Chicago 4.0 classification should be used judiciously in children. Manometric studies can guide the proper management of dysmotility in children.

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Bolus transit of upper esophageal sphincter on high-resolution impedance manometry study correlate with the laryngopharyngeal reflux symptoms

Hsu

Tsai

et al. 2021

Sci Rep

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Laryngopharyngeal reflux symptom is a troublesome upper esophageal problem, and reflux symptom index (RSI) is commonly applied for the assessment of clinical severity. We investigated the relationship between the upper esophageal sphincter impedance integral (UESII) and RSI scores in this study. Totally 158 subjects with high-resolution esophageal impedance manometry (HRIM) with RSI questionnaire assessment were recruited. There are 57 (36.08%), 74 (46.84%), 21 (13.29%), and 6 (3.79%) patients were categorized as normal, ineffective esophageal motility disorder, absent contractility, and achalasia by HRIM examination, respectively. Subjects with RSI > 13 were noted to have lower UESII than others with RSI ≦ 13 (7363.14 ± 1085.58 vs. 11,833.75 ± 918.77 Ω s cm; P < 0.005). The ROC analysis yielded a UESII cutoff of < 2900 Ω s cm for the best prediction of subjects with RSI > 13 (P = 0.002). Both female gender and UESII cutoff of < 2900 Ω s cm were significant predictors of RSI > 13 in logistic regression analysis (OR = 3.84 and 2.83; P = 0.001 and 0.01; respectively). Lower UESII on HRIM study, indicating poor bolus transit of UES during saline swallows, is significantly associated with prominent laryngopharyngeal reflux symptoms scored by RSI score.

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Distal contractile to impedance integral ratio assist the diagnosis of pediatric ineffective esophageal motility disorder

Cited by 4 publications

References 31 publications

Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms

Role of esophageal manometry in children with refractory gastroesophageal reflux symptoms

High-resolution esophageal manometry in children

Bolus transit of upper esophageal sphincter on high-resolution impedance manometry study correlate with the laryngopharyngeal reflux symptoms

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