Pathological Implications of Swallow-Associated Transient Lower Esophageal Sphincter Elevation

The Value of High-Resolution Manometry in Measurement of EGJ Competency and Manometric Outcomes of Antireflux Surgery

“…These findings indicate that a swallow-associated tHH could be an early indicator of dynamic EGJ failure. 17 It remains to be seen whether the patients in whom abnormal tHH is noted (as observed by Masuda et al 16,17 ) would develop a definite LES-CD separation if they underwent ambulatory manometry (as observed by Bredenoord et al 15 ). A summary of the literature correlating tHH or LES-CD overlap at baseline with reflux is presented in Table 2.…”

“…They subsequently published 2 studies looking at patterns (distance and temporality) of swallow-associated LES-CD separation and correlated their findings with distal esophageal acid exposure. 16,17 They reported that a tHH ≥1 cm in ≥30% swallows or ≥2 cm in ≥10% swallows was associated with abnormal distal esophageal acid exposure and therefore considered abnormal. A less frequent separation or a shorter distance of LES-CD separation was not associated with abnormal reflux.…”