Functional aspects of distal oesophageal spasm: The role of onset velocity and contraction amplitude on bolus transit

Pohl, Daniel; Ciolino, Jody D.; Roberts, Jason; Savarino, Edoardo; Freeman, Janice; Nietert, Paul J.; Tutuian, Radu; Castell, Donald O.

doi:10.1016/j.dld.2012.02.003

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…Using combined impedancemanometry additional data about esophageal motor function and associated bolus transport can be obtained during a single investigation without the use of radiation [22] Savarino et al showed a correlation between esophageal motor abnormalities and bolus transit defects in different subcategory of GERD patients [23]. Moreover, Pohl D et al proposed a bolus velocity cut-off in diagnosing patients with esophageal spasm and abnormal bolus transit [24].…”

Section: Esophageal Physiologymentioning

confidence: 99%

Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Savarino

Bortoli

Bellini

et al. 2016

Digestive and Liver Disease

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Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders. The following recommendations were developed to assist physicians in the appropriate use of esophageal manometry in modern patient care. They were discussed and approved after a comprehensive review of the medical literature pertaining to manometric techniques and their recent application. This position statement created under the auspices of the Gruppo Italiano di Studio per la Motilità dell'Apparato Digerente (GISMAD), Società Italiana di Gastroenterologia ed Endoscopia Digestiva (SIGE) and Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri (AIGO) is intended to help clinicians in applying manometric studies in the most fruitful manner within the context of their patients with esophageal symptoms.

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Section: Esophageal Physiologymentioning

confidence: 99%

Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Savarino

Bortoli

Bellini

et al. 2016

Digestive and Liver Disease

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Distal Esophageal Spasm: An Update

Achem

Gerson

2013

Curr Gastroenterol Rep

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Distal esophageal spasm (DES) is an esophageal motility disorder that presents clinically with chest pain and/or dysphagia and is defined manometrically as simultaneous contractions in the distal (smooth muscle) esophagus in ≥20% of wet swallows (and amplitude contraction of ≥30 mmHg) alternating with normal peristalsis. With the introduction of high resolution esophageal pressure topography (EPT) in 2000, the definition of DES was modified. The Chicago classification proposed that the defining criteria for DES using EPT should be the presence of at least two premature contractions (distal latency<4.5 s) in a context of normal EGJ relaxation. The etiology of DES remains insufficiently understood, but evidence links nitric oxide (NO) deficiency as a culprit resulting in a disordered neural inhibition. GERD frequently coexists in DES, and its role in the pathogenesis of symptoms needs further evaluation. There is some evidence from small series that DES can progress to achalasia. Treatment remains challenging due in part to lack of randomized placebo-controlled trials. Current treatment agents include nitrates (both short and long acting), calcium-channel blockers, anticholinergic agents, 5-phosphodiesterase inhibitors, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. Acid suppression therapy is frequently used, but clinical outcome trials to support this approach are not available. Injection of botulinum toxin in the distal esophagus may be effective, but further data regarding the development of post-injection gastroesophageal reflux need to be assessed. Heller myotomy combined with fundoplication remains an alternative for the rare refractory patient. Preliminary studies suggest that the newly developed endoscopic technique of per oral endoscopic myotomy (POEM) may also be an alternative treatment modality.

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

Savarino

Marabotto

Bodini

et al. 2019

Expert Review of Gastroenterology & Hepatology

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Functional aspects of distal oesophageal spasm: The role of onset velocity and contraction amplitude on bolus transit

Cited by 4 publications

References 32 publications

Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Distal Esophageal Spasm: An Update

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

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