The Clinical Usefulness of Functional Luminal Imaging Probe in Esophageal Dysmotility Disorder

Jung, Kee Wook

doi:10.5056/jnm22135

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…In contrast, FLIP can assess the distensibility of the esophageal tract and identify non‐occluding lumen contractions. Moreover, it assesses the “esophageal response to distension” with a degree of active distension from the FLIP filling protocol 6 . Of particular interest was the observation that all four patients who underwent FLIP had abnormal results.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] In addition, FLIP can reveal abnormal findings, such as decreased esophageal distensibility and abnormal contractile response to distention in symptomatic patients with normal manometry or ineffective esophageal motility. [4][5][6][7][8] However, no previous study has described these patients in terms of their clinical presentation or esophageal wall imaging findings. It remains unclear as to when to perform FLIP in patients with dysphagia who meet the criteria of normal or IEM according to CCv 4.0 and show other nonspecific findings on high-resolution manometry (HRM); particularly, we have noted that some of these patients show a distinctive repetitive pattern (i.e., repetitive simultaneous contractions [RSCs]) in their HRM that have not been previously defined or fall within the Chicago classification.…”

Section: Introductionmentioning

confidence: 99%

“…One of the differences between CCv 4.0 and version 3.0 is the recommended use of a functional luminal imaging probe (FLIP) following an inconclusive diagnosis of achalasia and esophagogastric junction outflow obstruction (EGJOO) 1–3 . In addition, FLIP can reveal abnormal findings, such as decreased esophageal distensibility and abnormal contractile response to distention in symptomatic patients with normal manometry or ineffective esophageal motility 4–8 . However, no previous study has described these patients in terms of their clinical presentation or esophageal wall imaging findings.…”

Section: Introductionmentioning

confidence: 99%

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Dysphagia associated with esophageal wall thickening in patients with nonspecific high‐resolution manometry findings: Understanding motility beyond the Chicago classification version 4.0

Choi,

Jung,

Pandolfino

et al. 2024

Neurogastroenterology Motil

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BackgroundPrevious studies have demonstrated that 50% of patients with normal high‐resolution manometry (HRM) findings or ineffective esophageal motility (IEM) may have abnormal functional luminal imaging probe (FLIP) results. However, the specific HRM findings associated with abnormal FLIP results are unknown. Herein, we investigated the relationship between nonspecific manometry findings and abnormal FLIP results.MethodsWe retrospectively analyzed 684 patients who underwent HRM at a tertiary care center in Seoul, Korea, based on the Chicago Classification version 4.0 protocol.Key ResultsAmong the 684 patients, 398 had normal HRM findings or IEM. Of these 398 patients, eight showed esophageal wall thickening on endoscopic ultrasonography or computed tomography; however, no abnormalities were seen during esophagogastroduodenoscopy. Among these eight patients, seven showed repetitive simultaneous contractions (RSCs) in at least one of the two positions: 61% (±29%) in 10 swallows in the supine position and 51% (±30%) in five swallows in the upright position. Four patients who underwent FLIP had a significantly decreased esophagogastric junction distensibility index (1.0 ± 0.5 at 60 mL). Two of these patients underwent per‐oral endoscopic myotomy (POEM) due to a lack of response to medication. Esophageal muscle biopsy revealed hypertrophic muscle with marginal eosinophil infiltration.Conclusions & InferencesA subset of patients (2%) with normal HRM findings or IEM and RSCs experienced dysphagia associated with poor distensibility of the thickened esophageal wall. FLIP assessment or combined HRM and impedance protocols may help better define these patients who may respond well to POEM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dysphagia associated with esophageal wall thickening in patients with nonspecific high‐resolution manometry findings: Understanding motility beyond the Chicago classification version 4.0

Choi,

Jung,

Pandolfino

et al. 2024

Neurogastroenterology Motil

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Anesthesia choice and its potential impact on endoluminal functional lumen imaging probe measurements in esophageal motility disorders

Canakis,

Lee,

Grossman

et al. 2024

Gastrointestinal Endoscopy

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Emerging Issues in Dysphagia

Jung

2023

Journal of the Korean Dysphagia Society

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Dysphagia is a common symptom with various causes, and technological advancements have improved efforts directed toward finding the cause of dysphagia. High-resolution manometry based on spatiotemporal plots has been used clinically since the 2000s, and version 4.0 of the high-resolution manometry-based Chicago classification with a revised protocol was suggested in 2021. Development of the functional lumen imaging probe (FLIP), used in conjunction with manometry, has broadened our understanding of esophageal motility disorders by providing measures of passive outer distensibility of the esophageal body and sphincter. Eosinophilic esophagitis is another esophageal disease with an increasing incidence in Korea. Greater understanding of the diagnosis and treatment of these diseases is needed. (JKDS 2023;13:1-7

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The Clinical Usefulness of Functional Luminal Imaging Probe in Esophageal Dysmotility Disorder

Cited by 3 publications

References 26 publications

Dysphagia associated with esophageal wall thickening in patients with nonspecific high‐resolution manometry findings: Understanding motility beyond the Chicago classification version 4.0

Dysphagia associated with esophageal wall thickening in patients with nonspecific high‐resolution manometry findings: Understanding motility beyond the Chicago classification version 4.0

Anesthesia choice and its potential impact on endoluminal functional lumen imaging probe measurements in esophageal motility disorders

Emerging Issues in Dysphagia

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