The effect of position on esophageal structure and function determined with solid‐state high‐resolution manometry

Zhang, Xiu Jing; Xiang, Xue; Tu, Lei; Xie, Xiaozhu; Hou, Xiao Hua

doi:10.1111/1751-2980.12256

Cited by 8 publications

(16 citation statements)

References 29 publications

(54 reference statements)

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“…In addition, although HRM can be performed in both supine and sitting positions, HRM was conducted only in an upright sitting position in the present study. Zhang et al [ 34 ] reported that there was no difference in UES basal pressure between sitting and supine position measured using HRM. However, to our knowledge, there has been no previous study that evaluated the effect of posture on VP and TB pressure using HRM.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

et al. 2017

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ObjectiveTo compare swallowing function between healthy subjects and patients with pharyngeal dysphagia using high resolution manometry (HRM) and to evaluate the usefulness of HRM for detecting pharyngeal dysphagia.MethodsSeventy-five patients with dysphagia and 28 healthy subjects were included in this study. Diagnosis of dysphagia was confirmed by a videofluoroscopy. HRM was performed to measure pressure and timing information at the velopharynx (VP), tongue base (TB), and upper esophageal sphincter (UES). HRM parameters were compared between dysphagia and healthy groups. Optimal threshold values of significant HRM parameters for dysphagia were determined.ResultsVP maximal pressure, TB maximal pressure, UES relaxation duration, and UES resting pressure were lower in the dysphagia group than those in healthy group. UES minimal pressure was higher in dysphagia group than in the healthy group. Receiver operating characteristic (ROC) analyses were conducted to validate optimal threshold values for significant HRM parameters to identify patients with pharyngeal dysphagia. With maximal VP pressure at a threshold value of 144.0 mmHg, dysphagia was identified with 96.4% sensitivity and 74.7% specificity. With maximal TB pressure at a threshold value of 158.0 mmHg, dysphagia was identified with 96.4% sensitivity and 77.3% specificity. At a threshold value of 2.0 mmHg for UES minimal pressure, dysphagia was diagnosed at 74.7% sensitivity and 60.7% specificity. Lastly, UES relaxation duration of <0.58 seconds had 85.7% sensitivity and 65.3% specificity, and UES resting pressure of <75.0 mmHg had 89.3% sensitivity and 90.7% specificity for identifying dysphagia.ConclusionWe present evidence that HRM could be a useful evaluation tool for detecting pharyngeal dysphagia.

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Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

et al. 2017

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“…One thousand seven hundred fourteen patients were included, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] of whom 1284 were symptomatic and 430 asymptomatic individuals. The sequence of the position assumed during HRM was described in almost all studies.…”

Section: High-resolution Manometry Protocolsmentioning

confidence: 99%

“…Some authors referred that the exam was started in the supine position and the subsequent series of swallows was performed in the sitting/upright position; 12,14,15,18,19,24 other referred the opposite. 16,20,22,23 both to the upright or supine position in the studies by Zhang et al 17,21 and Misselwitz et al 26 Only 5 studies 14,16,17,19,24 reported the inclination assumed by the patient during the exam: between 0° and 20° for the supine position and between 75° and 90° for the upright/sitting position. Every study included at least 5 water bolus swallows per set for each position.…”

Section: High-resolution Manometry Protocolsmentioning

confidence: 99%

“…Every study included at least 5 water bolus swallows per set for each position. Data were analyzed using various manometric softwares: 12 studies [11][12][13][14]16,17,[19][20][21][24][25][26] used Manoscan (of whom 3 and 9 from Medtronic [Minneapolis, MN, USA]), 3 studies 15,22,23 used Bioview by Sandhill Scientific Inc (Ranch, CO, USA), and 2 studies 10,18 used Trace! V1.2 videomanometry system (Hebbard System, Melbourne, Australia) ( Table 1).…”

Section: High-resolution Manometry Protocolsmentioning

confidence: 99%

“…In regard to LES parameters, LES length was analyzed in 5 studies, 11,15,19,21,23 3 of which 15,21,23 found a greater LES length in the supine position. Six 15,20,21,23,24,26 of 8 studies 11,12,15,20,21,23,24,26 showed a significant increase in LES basal pressure in the supine position, 3 studies [11][12][13] did not find differences, and one 19 found a significantly higher pressure in the upright position. IRP was significantly higher in the supine position in 10 of 13 studies, [14][15][16][17][20][21][22][23][24]26 while in 2 studies 13,18 it was significantly increased in the upright position.…”

Section: High-resolution Manometry Variablesmentioning

confidence: 99%

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Effect of Body Position on High-resolution Esophageal Manometry Variables and Final Manometric Diagnosis

Riva

Siboni

Ferrari

et al. 2020

J Neurogastroenterol Motil

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Background/Aims According to the Chicago classification version 3.0, high-resolution manometry (HRM) should be performed in the supine position. However, with the patient in the upright/sitting position, the test could more closely simulate real-life behavior and may be better tolerated. We performed a systematic review of the literature to search whether the manometric variables and the final diagnosis are affected by positional changes. Methods A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Studies published in English that compared HRM results in different body positions were included. Moreover, the change in diagnosis of esophageal motility disorders according to the shift of body position was investigated. Results Seventeen studies including 1714 patients and healthy volunteers met the inclusion criteria. Six studies showed a significant increase in lower esophageal sphincter basal pressure in the supine position. Integrated relaxation pressure was significantly higher in the supine position in 10 of 13 studies. Distal contractile index was higher in the supine position in 9 out of 10 studies. One hundred and fifty-one patients (16.4%) out of 922 with normal HRM in the supine position were diagnosed with ineffective esophageal motility (IEM) when the test was performed in the upright position (P < 0.001). Conclusions Performing HRM in the upright position affects some variables and may change the final manometric diagnosis. Further studies to determine the normal values in the sitting position are needed.

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The upper esophageal sphincter in the high-resolution manometry era

Norton

Herbella

Schlottmann

et al. 2021

Langenbecks Arch Surg

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The effect of position on esophageal structure and function determined with solid‐state high‐resolution manometry

Abstract: Body position exerts a greater influence on the LES than on the UES. Thus, it is necessary to establish normal values for the LES basal pressure and residual pressure in different positions.

Cited by 8 publications

References 29 publications

Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

Effect of Body Position on High-resolution Esophageal Manometry Variables and Final Manometric Diagnosis

The upper esophageal sphincter in the high-resolution manometry era

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