AIM: High-resolution manometry (HRM) provides a spatially enhanced, dynamic representation of the esophagogastric junction (EGJ) high-pressure zone making it possible to isolate the crural diaphragm (CD) contraction from expiratory lower esophageal sphincter (LES) pressure. This study compared CD function of subjects with and without gastroesophageal reflux disease (GERD). METHODS: A ...

PURPOSE: This study compared the clinical and physiological results of non-sphincter splitting fistulectomy (N-SSF) with those of sphincter splitting fistulotomy (SSF) for treatment of high trans-sphincteric fistula-in-ano. MATERIALS AND METHODS: A prospective, observational study was undertaken in 70 consecutive patients with high trans-sphincteric fistula treated by SSF (n = 35) ...

AIMS: The aim of this study was to evaluate the anal manometric changes and the clinical effects after topical application of isosorbide dinitrate (ISDN) in patients with persistent constipation after pull-through surgery for Hirschsprung's disease (HD). METHODS: We studied 3 children (2 males and 1 female), aged 2, 3 and ...

BACKGROUND: Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to introduce an easy and reproducible method for measuring anal pressures in testing the ...

PURPOSE: To describe timed barium esophagogram (TBE) characteristics in patients with newly diagnosed idiopathic achalasia, and to correlate these with clinical and manometric variables. MATERIAL AND METHODS: Forty-six consecutive patients with newly diagnosed achalasia were examined with TBE. Esophageal emptying was assessed using the height, area, and volume of the ...

Gabexate mesilate (GM) relaxes the papilla of Vater in addition to inhibiting the several proteases. We evaluated whether prophylactic administration of GM would prevent the occurrence of acute pancreatitis in endoscopic papillary balloon dilation (EPBD). Nineteen patients with common bile duct stones were separated into two groups according to the ...

This article reviews and places into context the development of lower oesophageal sphincter (LOS) manometry, the key technique for researching the mechanics of this region. The first of two major challenges, being able to record sphincter pressure accurately with generally available equipment, was solved by the advent of perfused manometry ...

BACKGROUND AND AIMS: This study was undertaken to determine the incidence of and risk factors for anal incontinence after fistulotomy for intersphincteric fistula-in-ano. We also evaluated the role of anal manometry in preoperative assessment of intersphincteric fistula. MATERIALS AND METHODS: A prospective, observational study was undertaken in 148 patients who ...

The lower esophageal sphincter (LES) is the primary barrier to gastroesophageal reflux. Reflux is associated with periods of LES relaxation, as occurs during swallowing. Continuous positive airway pressure (CPAP) has been shown to reduce reflux in individuals with and without sleep apnea, by an unknown mechanism. The aim of this ...

Controlled distension of hollow organs is an accepted technique for generating reproducible visceral stimuli. We have constructed a new, flexible and intelligent distension system in which discomfort, pain and autonomic responses are recorded online. These responses can be fed back into the system in a regulatory loop and be used ...

BACKGROUND: Increased maximum resting anal pressures (MRAP) have been found in patients with large prolapsed hemorrhoids undergoing hemorrhoidectomy, but their pathogenic role is controversial especially in view of the sphincteric damage that occurs with open and stapled procedures. This prospective randomized clinical trial was conducted to compare anal pressure changes ...

BACKGROUND: Intrathoracic periesophageal fundoplication carries a high risk of treacherous technical complications such as spontaneous gastric perforation. METHODS: An intrathoracic fundoplication was performed on 84 patients suffering from gastroesophageal reflux disease with the junction between upper gastric folds and the unwrinkled esophageal mucosa remaining above the diaphragm while the esophageal ...

The assessment of parameters which adequately represent rectal and neorectal compliance is complex. Biological properties of the rectum during distension and relaxation show significant departures from in vitro physical compliance measurements; as much dependent upon the viscoelastic charateristics of hollow organ deformation as upon the technique of compliance calculation. This ...

BACKGROUND AND STUDY AIMS: Implantable microstimulators (IMS) have been used in a variety of medical conditions. Selective stimulation to increase lower esophageal sphincter (LES) pressure may be useful in the control of gastroesophageal reflux disease. We evaluated on-demand stimulation of the LES with an endoscopically implanted microstimulator. MATERIALS AND METHODS: ...

BACKGROUND: The purpose of our study was to assess anal function in professional mountain bikers, as an increasing number of cycling enthusiasts report functional and morphological problems in the anal region. We tried to find out if constant saddle vibration suffered by professional cyclists could lead to defecation disorders. METHODS: ...

Nutcracker esophagus (NE) is a primary esophageal motility disorder characterized by high-wave amplitude at the distal esophagus. The aim of this study was to analyze patients with NE and determine the relationship between distal esophageal contraction amplitude and lower esophageal sphincter (LES) pressure. Esophageal manometry tracings of patients with NE, ...

Post-ERCP pancreatitis (PEP) is a potential complication of ERCP. Pharmacotherapy for prevention of PEP aims at reducing basal sphincter pressure and contractility or a decrease in pancreatic secretion to reduce intraductal pressure. Timing and route of administration of drugs are critical to ensure maximum benefits from medications. Pancreatic stenting offers ...

The aim of this study was to determine whether attachment of the Bravo pH monitoring capsule alters esophageal motility. Twenty normal subjects were studied with 36-channel high-resolution manometry before and after Bravo capsule placement. Subjects performed 10 5-mL water-swallows in both upright and supine positions and two 5-mL barium-swallows under ...

INTRODUCTION: Effective antihypertensive therapy reduces the risk of cardiovascular and cerebrovascular disease and death. Perindopril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, is an established antihypertensive agent administered as a once-daily tablet. AIMS: To review recent evidence for the use of perindopril in the treatment of hypertension. EVIDENCE REVIEW: Evidence shows ...

AIM: To study the prolonged colonic motility under normal conditions with a novel capsule-style micro-system and to assess its clinical significance. METHODS: A single use telemetry capsule (10 mm in diameter, 20 mm in length) embedded with a pressure sensor was ingested by the subjects. The sensor is capable of ...

BACKGROUND: The current view holds that gastric emptying is effected by the force of the antral peristaltic wave squeezing food particles through pyloric sphincter resistance. Whether this is accomplished by a reflex action was investigated. MATERIAL/METHODS: The study comprised 12 healthy volunteers (age: 42.2+/-10.6 years). A balloon-tipped and a manometric ...

Colonic motility disorders are common conditions. However, our understanding of normal and pathological motor functions of the colon remains limited, mainly due to the technical difficulties in accessing this organ for study. To investigate colonic motility under normal physiological conditions, we have developed a novel monitoring system based on a ...

OBJECTIVES: The gold standard objective measure of pharyngeal strength is pharyngeal manometry. We have developed an objective fluoroscopic measure of pharyngeal strength, the pharyngeal constriction ratio (PCR). A high PCR indicates poor pharyngeal constriction. The objective of the current study was to evaluate the correlation between the PCR and peak ...

BACKGROUND: Anal inspection and digital rectal examination are routinely performed in fecal incontinent patients but it is not clear to what extent they contribute to the diagnostic work-up. We examined if and how findings of anal inspection and rectal examination are associated with anorectal function tests and endoanal ultrasonography. METHODS: ...

OBJECTIVE: This work establishes an animal model for nonadjustable gastric banding and characterizes the effect of gastric banding on esophageal physiology. SUMMARY BACKGROUND DATA: Obstruction at the esophagogastric junction (EGJ) results in esophageal dilation and aperistalsis. Although laparoscopic gastric banding as a primary treatment of morbid obesity has been widely ...

OBJECTIVE: Subjective assessment of primary achalasia is not accurate. We aimed to study the utility of surface area of barium retention in the objective assessment of these patients. METHODS: Subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated 1 ...

An artificial sphincter prototype has been developed, specifically designed for comfortable remote control by fecally incontinent patients. The artificial sphincter includes a fluid reservoir, an occlusive cuff, and a micropump based on piezo-technology in a single unit. Continence and implantation management were evaluated around isolated porcine anal canals and in ...

This study explored the influence of two methods of effortful swallow execution on the timing of pharyngeal pressure events. Participants were asked to either emphasize or minimize tongue-to-palate contact during performance of the maneuver. Twenty healthy participants were evaluated using concurrent submental surface electromyography (sEMG), orolingual manometry, and pharyngeal manometry. ...

The role of pelvic floor muscle contraction in the genesis of anal canal pressure is not clear. Recent studies have suggested that vaginal distension increases pelvic floor muscle contraction. We studied the effects of vaginal distension on anal canal pressure in 15 nullipara asymptomatic women. Anal pressure, rest, and squeeze ...

OBJECTIVES: Esophageal wave amplitude is an important determinant of esophageal clearance. A threshold of 30 mmHg is widely accepted as the threshold for effective clearance in the distal esophagus. However, the precise relationship between wave amplitude and clearance has received relatively little attention. The aim of this study was to ...

BACKGROUND: Tegaserod is a partial 5-hydroxytryptamine 4 receptor agonist with prokinetic effects on the gastrointestinal tract, its effects on oesophageal function are unknown. AIM: A randomized, placebo controlled, double-blind trial assessed the effect of tegaserod on the oesophagus in healthy, asymptomatic subjects. METHOD: A 7-day course of tegaserod 6 mg ...

BACKGROUND & AIMS: The aim of this study was to perform a detailed analysis of the mechanics leading to esophagogastric junction (EGJ) opening during transient lower esophageal sphincter relaxations (tLESRs) using high-resolution manometry coupled with simultaneous fluoroscopy. METHODS: Six subjects without hiatus hernia had endoclips placed at the squamocolumnar junction ...

In hypoxic stop-flow chemoperfusion high doses of chemotherapeutic agents are almost directly administered to locally advanced tumors without risking significant systemic toxicity, although chemotherapy-induced neurotoxicity is still a problem. The aim of the study was to assess rectoanal motility and sensation before, during and after abdominal and pelvic stop-flow chemotherapy ...

PURPOSE: This study was designed to investigate the changes in rectal compliance and tone during anal electric stimulation and the involvement of the alpha-adrenergic pathway in conscious dogs. METHODS: Eight healthy dogs were studied in five randomized sessions. Anal sphincter pressure was quantified by using the area under the contractile ...

There is a need for new methods to study the dynamics of the esophagogastric junction (EGJ). The aims were to verify the efficacy and usefulness of a "functional lumen imaging probe" (FLIP) for the evaluation of the EGJ. Eight healthy volunteers (6 men), median age 26 (21-35) yr, and two ...

BACKGROUND/AIM: We present 18 women who under normal conditions had fecal and flatus control. They leaked flatus only during coitus. We investigated the hypothesis that these women had a concealed anal sphincteric disorder. METHODS: Eighteen multiparous women (mean age 44.8+/-7.2 SD years) complained of involuntary passage of flatus during coitus ...

PURPOSE: Vectorgraphy as an integrated mapping of radial pressure profiles of the anal canal has been used to attempt identification of pressure-related defects with doubtful reliability since vectorgraphs bear no resemblance to endoanal ultrasound scans at similar levels in the anal canal. This study aimed to devise a technique to ...

AIM: To investigate whether the degree of rectal distension could define the rectum functions as a conduit or reservoir. METHODS: Response of the rectal and anal pressure to 2 types of rectal balloon distension, rapid voluminous and slow gradual distention, was recorded in 21 healthy volunteers (12 men, 9 women, ...

PURPOSE: Methods of anal manometry vary between centers, resulting in potential difficulties in interpretation of results. This study compared several accepted manometric techniques in healthy control subjects and in patients with fecal incontinence. METHODS: Eleven patients with fecal incontinence (M:F = 3:8; mean age = 67 years) and ten healthy ...

PURPOSE: Sacral nerve stimulation has proven to be a promising treatment for fecal incontinence when conventional treatment modalities have failed. There have been several hypotheses concerning the mode of action of sacral nerve stimulation, but the mechanism is still unclear. This study was designed to evaluate the results of rectal ...

An anal fissure is a painful linear ulcer in the lower part of the anal canal. It is very often referred to as an ischemic ulcer. Anodermal blood flow is negatively correlated with resting pressure of the anus. Increased activity of the internal anal sphincter may decrease the anodermal blood ...

PURPOSE: To evaluate, in dogs, the functions of biliary sphincter subjected to dilation hydrostatic balloon by the point of view of the radiographic and manometric alterations. METHODS: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10) - with balloon of 8mm inflated with pressure ...

INTRODUCTION: Oesophageal dysmotility contributes to the pathogenesis of Barrett's epithelium (BE) allowing prolonged mucosal contact with injurious refluxate. Argon plasma coagulation (APC) is effective for BE ablation, but it is unknown whether the procedure affects oesophageal motility. AIM: To assess the effect of low power (30 W) APC therapy on ...

The objective of this paper is to evaluate age and associated factors affecting anorectal pressure profilometry in anal-continent women with lower urinary tract symptoms. One hundred and ten anal-continent women (mean age, 47.7+/-12.8 years; range, 23-87 years) with lower urinary tract symptoms voluntarily participated in this study after undergoing a ...

Radial asymmetry of the upper oesophageal sphincter high-pressure zone (UESHPZ) is an accepted notion based on manometric studies. Our aim was to evaluate the effect of the catheter diameter and configuration on the resting pressure profile of the UES. We studied 14 young (30 +/- 2 years) and 14 healthy ...

Despite its role in disease there is still no definitive method to assess oesophago-gastric junction competence (OGJ). Traditionally the OGJ has been assessed using manometry with lower oesophageal sphincter pressure as the indicator. More recently this has been shown not to be a very reliable marker of sphincter function and ...

BACKGROUND: Resting and squeeze pressures in the anal canal are thought to reflect the contributions of the internal anal sphincter (IAS) and the external anal sphincter (EAS) respectively. Role of the puborectalis muscle (PRM) in the genesis of anal canal pressure is not known. OBJECTIVES: To determine the functional correlates ...

OBJECTIVE: A new distension paradigm, by which the gastric volume response to ramp-tonic distension can be analysed in detail, has been developed. The aim of this study was to investigate the applicability of this new paradigm in man, and to compare pressure-induced gastric accommodation in healthy volunteers (HV) and patients ...

Relaxation and opening of the oesophago-gastric junction (OGJ) is crucial for oesophageal transport. A novel ultrasound technique was used to determine OGJ opening, before and after atropine, in 12 normals. An ultrasound probe, a solid-state pressure transducer and an infusion tube were placed inside a 20-mm diameter bag, which was ...

This study aimed to use a novel high-resolution manometry (HRM) system to establish normative values for deglutitive upper esophageal sphincter (UES) relaxation. Seventy-five asymptomatic controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record from the hypopharynx to the stomach. Subjects ...