Identification of an abnormal esophageal clearance response to intraluminal distention in patients with esophagitis

Williams, David; Thompson, David G.; Marples, M.; Heggie, L; O'Hanrahan, Timothy; Mani, V; Bancewicz, J.

doi:10.1016/0016-5085(92)90028-w

Cited by 38 publications

(24 citation statements)

References 26 publications

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“…Williams et al [14] and Pouderoux et al [6] and co-workers used a strain gauge, but did not describe any technical details. The next series of publications were based on the use of a miniature strain gauge, and published in the period from 1992 to 1997 [6,[14][15][16][17] . A new technique, based on impedance planimetry, was introduced recently (2008) by our group [19] .…”

Section: Axial Force Recording Techniquesmentioning

confidence: 99%

“…However the data analysis for this study is not complete. Swallowing studies recording axial force have previously been performed with a balloon in the esophagus inflated with either air [11,12,14] or fluid [19] . Increased bag volume increased the axial force amplitude [11,14,15] .…”

Section: Issnmentioning

confidence: 99%

“…This method of quantifying peristalsis is referred to as propulsive force [6,[9][10][11][12][13] , traction force [6,[14][15][16][17] and peristaltic force [11,18] . We refer to these concepts as axial force as this is the direction of the force in contrast to manometry, which records the radial force.…”

Section: Introductionmentioning

confidence: 99%

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Axial force measurement for esophageal function testing

Gravesen¹,

Funch‐Jensen²,

Gregersen³

et al. 2009

WJG

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The esophagus serves to transport food and fluid from the pharynx to the stomach. Manometry has been the "golden standard" for the diagnosis of esophageal motility diseases for many decades. Hence, esophageal function is normally evaluated by means of manometry even though it reflects the squeeze force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe with combined axial force and manometry recordings showed that axial force amplitude increased by 130% in contrast to an increase of 30% using manometry. Using axial force in combination with manometry provides a more complete picture of esophageal motility, and the current paper outlines the advantages of using this method.

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Section: Axial Force Recording Techniquesmentioning

confidence: 99%

Section: Issnmentioning

confidence: 99%

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Axial force measurement for esophageal function testing

Gravesen¹,

Funch‐Jensen²,

Gregersen³

et al. 2009

WJG

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“…Because secondary peristalsis seems to share a common motor pathway with primary peristalsis this side of the reflex would seem to be intact, implying that the defect in secondary peristalsis is due either to an abnormality of oesophageal sensation or in the integration of sensory information with the motor component of the reflex . This hypothesis is supported by the findings of Williams et al who noted that the distension threshold required to trigger a motor response was higher in patients with oesophagitis than in healthy controls (Williams et al,1992). Others, however, have found no difference in the threshold volume required to trigger oesophageal motor responses using slow (1 ml/s) infusions (Corazziari et al,1986).…”

Section: Wwwintechopencommentioning

confidence: 75%

“…Thus, these patients are prone to severe mucosal injury (including Barrett's esophagus) and frequent extra-esophageal symptoms such as cough (Herbella & Patti, 2010;Patti & Perretta, 2003;Meneghetti et al,2005). In addition to primary peristalsis alterations, patients with GERD have secondary peristalsis impairments and in most of them the esophageal distension is not capable of triggering secondary peristaltic contractions (Williams et al,1992). As this deficit can occur even in subjects with normal primary peristalsis has been suggested that the phenomenon is due to an altered response to esophageal acid reflux and / or relaxing .…”

Section: Wwwintechopencommentioning

confidence: 99%

Esophageal Motility and Gastroesophageal Reflux

Grande¹,

Villa²,

Cadeddu³

2012

Gastroesophageal Reflux Disease

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Effect of Reflux and Esophagitis on Esophageal Volume and Acid Clearance in Piglets

Vicente,

da Rocha,

Perez‐Mies

et al. 2004

J. pediatr. gastroenterol. nutr.

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Background/aimsThe study investigates esophageal motor function and esophageal clearance immediately after surgical induction of reflux in piglets and 8 weeks later after peptic esophagitis has developed.MethodsTwenty‐four sedated, nonintubated piglets were divided into three groups: sham (laparotomy only), reflux (distal esophageal myotomy), and reflux + esophagitis (8 weeks after myotomy). All animals underwent stationary manometry of the esophagus with a four‐lumen perfused assembly after injection of 1‐, 2‐, and 3‐mL boluses of saline and acid into the proximal esophagus. Simultaneous pH monitoring allowed assessment of acid clearance. Wave features and clearance times after saline and acid were compared among groups.ResultsThere were minor changes in peristaltic activity of the esophagus after saline boluses in animals with reflux. Acid clearance time was prolonged, especially the time to re‐establish resting esophageal pH, in animals with esophagitis. These changes, which were volume‐dependent, were related to the loss of peristaltic organization of the esophageal waves. The esophageal wave frequency, amplitude, and duration were only slightly changed by the induction of reflux and by esophagitis.ConclusionsThe esophagus affected by acid reflux, with or without esophagitis, was capable of near‐normal motor responses after boluses of saline. Reflux impaired the peristaltic response to acid, and the effect was more pronounced when reflux and esophagitis were both present. The acid clearance time was also strikingly prolonged in the presence of reflux and esophagitis. The results suggest that long episodes of reflux seen on pH tracings from individuals with esophagitis might be secondary both to acid‐related motor dysfunction and large volumes of refluxate.

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Identification of an abnormal esophageal clearance response to intraluminal distention in patients with esophagitis

Cited by 38 publications

References 26 publications

Axial force measurement for esophageal function testing

Axial force measurement for esophageal function testing

Esophageal Motility and Gastroesophageal Reflux

Effect of Reflux and Esophagitis on Esophageal Volume and Acid Clearance in Piglets

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