Evaluation of Esophageal Motor Function With High-resolution Manometry

Abstract

For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address.

Comparison of High-resolution Anorectal Manometry With Water-perfused Anorectal Manometry

“…Also, the direction, power and peristalsis of intra-esophageal pressure as presented in spatiotemporal plots allow clinicians to distinguish an abnormal from a normal esophageal motility pattern. [11][12][13] Therefore, a high-resolution system is characterized by: (1) a simplified set up with improved sphincter localization, (2) elimination of movement artifacts, (3) simplified data interpretation, (4) the ability to perform a more sophisticated analysis 14 , and (5) ease of reporting and storing the patient reports due to use of dedicated software.…”

Cómo realizar e interpretar una manometría esofágica de alta resolución usando la clasificación de Chicago 3.0

“…En la década de 1990, Ray Clouse y sus colegas dieron nacimiento a la manometría de alta resolución (MAR) al disminuir el espacio entre los sensores ubicados a lo largo del catéter de presión de manometría convencional de 5 cm a 1 cm y aumentó el número de sensores y la longitud del segmento sensado desde la faringe hasta el estómago, por lo que logró observar la función motora del esfínter esofágico superior (EES) y el esfínter esofágico inferior (EEI) con cada deglución, lo que ofrece una descripción temporoespacial completa de la función motora esofágica (1,2).…”

Chicago classification of high-resolution esophageal manometry: Is old the gold or is new better?

“…In this new technology, pressure profile is assessed during several liquid and viscous swallows using a catheter having a large number of ports at closely spaced positions in the esophagus [2]. Time, catheter position, and average pressure are then reconstructed into pseudo-3D "topographic plots" that demonstrated the functional anatomy of the esophagus and that of the gastroesophageal junction taking gastric pressure as the baseline [2].There are several advantages of HRM over conventional manometry [2][3][4][5][6][7]. The advantages may be broadly classified into two groups, (a) those related to the recording of the data and (b) those related to the display of the data.…”

“…There are several advantages of HRM over conventional manometry [2][3][4][5][6][7]. The advantages may be broadly classified into two groups, (a) those related to the recording of the data and (b) those related to the display of the data.…”