Normal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry

Carlson, Dustin A.; Kou, Wenjun; Lin, Zhiyue; Hinchcliff, Monique; Thakrar, Anjali; Falmagne, Sophia; Prescott, Jacqueline; Dorian, Emily; Kahrilas, Peter J.; Pandolfino, John E.

doi:10.1016/j.cgh.2018.07.042

Cited by 127 publications

(173 citation statements)

References 17 publications

Supporting

Mentioning

163

Contrasting

Unclassified

Order By: Relevance

“…For comparison, 20 healthy, asymptomatic, adult volunteers were also included. These subjects were previously described . Informed consent was obtained from all subjects.…”

Section: Methodsmentioning

confidence: 99%

“…Functional luminal imaging probe data including distension volume, intra‐balloon pressure, and 16 channels of luminal diameter were exported to a customized program as previously described . Esophageal body contractions and contractility patterns were identified similarly to previous studies . Esophageal body contractions were identified by a transient decrease of ≥5 mm in the luminal diameter in ≥3 adjacent impedance planimetry channels using FLIP topography plots and 16‐channel diameter line‐tracing output.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The rhythm and rate of distension‐induced esophageal contractility: A physiomarker of esophageal function

Carlson

Kou

Pandolfino

2020

Neurogastroenterology Motil

Self Cite

View full text Add to dashboard Cite

Background Distention of the esophagus elicits a unique pattern of repetitive contractions in healthy controls. We aimed to assess the rhythm and rate of distension‐induced contractile patterns between achalasia and controls and identify factors that distinguish the normal contractile response to distension. Methods Twenty asymptomatic controls and 140 adult patients with treatment‐naïve achalasia defined by HRM (29 type I, 81 type II, 30 type III) were prospectively evaluated with functional luminal imaging probe (FLIP) during sedated endoscopy. 16‐cm FLIP balloons were positioned within the distal esophagus during stepwise balloon distension. Functional luminal imaging probe panometry studies were retrospectively analyzed using a customized program. Key results All controls had contractility in a repetitive antegrade contraction (RAC) pattern with a rate of mean (10‐90th) 6 (4‐8) contractions per minute. 19/20 controls had > 6 consecutive antegrade contractions (ACs), that is, duration > 6 ACs, >6 cm in length, at a rate of 6 ± 3 contractions per minute (met the “Rule‐of‐6s”). 50 achalasia patients had repetitive contractions that occurred at a rates of 11 (7 ‐ 15) ACs per minute; P < .001 compared with controls, or 12 (8‐15) repetitive retrograde contractions per minute. Only 1/140 achalasia patients had a contractile response that met the “Rule‐of‐6s.” Conclusion The normal contractile response to sustained distention is associated with > 6 RACs with a consistent rate of 6 ± 3 per minute, which was exceptionally rare in achalasia. These findings support that the RAC pattern is disrupted in achalasia and the faster rate may be a manifestation of abnormal inhibition and/or a reduced refractory period.

show abstract

“…For comparison, 20 healthy, asymptomatic, adult volunteers were also included. These subjects were previously described . Informed consent was obtained from all subjects.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The rhythm and rate of distension‐induced esophageal contractility: A physiomarker of esophageal function

Carlson

Kou

Pandolfino

2020

Neurogastroenterology Motil

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a recent prospective study conducted by Carlson et al the normative data of FLIP in 20 asymptomatic volunteers were evaluated across the EGJ and distal esophagus. The average EGJ distensibility index (DI) was greater than 2.8 mm 2 /mmHg, and distensibility plateaus were greater than 18 mm in all particiants . Therefore, normal DI parameters for the esophagus can be used to facilitate the application of FLIP in esophageal diseases in clinical practice.…”

Section: Flip For Egj Evaluationmentioning

confidence: 99%

“…The average EGJ distensibility index (DI) was greater than 2.8 mm 2 /mmHg, and distensibility plateaus were greater than 18 mm in all particiants. 8 Therefore, normal DI parameters for the esophagus can be used to facilitate the application of FLIP in esophageal diseases in clinical practice.…”

Section: Flip For Egj Evaluationmentioning

confidence: 99%

Functional lumen imaging probe in gastrointestinal motility diseases

Chen

et al. 2019

J of Digest Diseases

View full text Add to dashboard Cite

Dysfunction of gastrointestinal (GI) sphincters, including the lower esophageal sphincter (LES) at the esophagogastric junction (EGJ) and the pyloric sphincter, plays a vital role in GI motility disorders, such as achalasia, gastroesophageal reflux disease (GERD), gastroparesis, and fecal incontinence. Using multi‐detector high‐resolution impedance planimetry, the functional luminal imaging probe (FLIP) system measures simultaneous data on tissue distensibility and luminal geometry changes in the sphincter in a real‐time manner. In this review we focus on the emerging data on FLIP, which can be used as an innovative diagnostic method during endoscopic or surgical procedures in GI motility disorders. Subsequent large, prospective, standardizing studies are needed to validate these findings before it can be put to routine clinical use.

show abstract

“…Acceptability of procedure, measured using visual analog scale (VAS), was significantly higher for Cytosponge (median, 6. In this study of 20 healthy volunteers, Carlson and colleagues 5 established normal values of esophageal distensibility and distension-induced contractility using FLIP. Using a 16-cm FLIP positioned across the esophagogastric junction (EGJ) and distal esophagus, they observed that all 20 asymptomatic subjects had an EGJ distensibility index > 2.8 mm 2 /mmHg, maximum EGJ diameter > 18 mm, distal esophageal body distensibility plateau > 18 mm, and exhibited a pattern of repetitive antegrade contractions in response to distension.…”

Section: Safety and Acceptability Of Esophageal Cytosponge Cell Collementioning

confidence: 99%

Issue Highlights

Singh

2019

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

Normal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry

Cited by 127 publications

References 17 publications

The rhythm and rate of distension‐induced esophageal contractility: A physiomarker of esophageal function

The rhythm and rate of distension‐induced esophageal contractility: A physiomarker of esophageal function

Functional lumen imaging probe in gastrointestinal motility diseases

Issue Highlights

Contact Info

Product

Resources

About