BACKGROUND: This study aimed to evaluate the pharyngeal pressure of a patient with, amyotrophic lateral sclerosis (ALS) before and after cricopharyngeal myotomy by high-resolution manometry (HRM) system. METHODS: A 60-year-old man with ALS underwent cricopharyngeal myotomy for his intractable, aspiration. The swallowing pressure along the velopharynx and upper esophagus was ...

INTRODUCTION: Most patients with fecal incontinence have poor anal sphincter function. In patients with idiopathic fecal incontinence no structural abnormality can be identified. The aim of the present study was to compare rectal motility patterns in patients with idiopathic fecal incontinence and in healthy controls. METHODS: Rectal impedance planimetry provides ...

AIM: Anal manometry is an established assessment tool for patients with faecal incontinence. Fatigue rate index (FRI) has been shown to discriminate between symptomatic patients and controls. The aim of this study was to compare manometry and fatigability of the anal canal in nulliparous women before and after childbirth. METHOD: ...

Esophageal manometry (EM) findings were reviewed in 14 (13 male) adults diagnosed with eosinophilic esophagitis (EE). One had complete nonperistaltic contractions (amplitude range = 30-180 mmHg) and incomplete relaxation of the lower esophageal sphincter (LES), suggesting vigorous achalasia. After 6 months of steroid therapy the repeat EM showed near-normal findings. ...

BACKGROUND: The components of esophageal function important to success with laparoscopic adjustable gastric banding (LAGB) are not well understood. A pattern of delayed, however, successful bolus transit across the LAGB is observed. METHODS: Successful LAGB patients underwent a high-resolution video manometry study in which bolus clearance, flow, and intraluminal pressures ...

Distention of the proximal colon may have inhibitory or excitatory effects on the rectum and vice versa. The reflexes between the proximal colon and the rectum have not been well studied due to difficulties in accessing the proximal colon. The aim of this study was to investigate the reflex responses ...

PURPOSE This prospective investigation evaluates oral weakness and its impact on swallow function, weight and quality of life in patients with OPMD. METHODS Intraoral pressure, swallow pressure and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched controls. Timed water swallow, weight and quality ...

OBJECTIVE: The present study aimed to assess the occurrence of trigeminocardiac reflex (TCR) during Le Fort I osteotomies. STUDY DESIGN: This case-crossover study included 25 Le Fort I osteotomy candidates without systemically compromising conditions. Mean arterial blood pressure and pulse rate values were recorded before downfracture (DF) (MABP1, PR1), during ...

OBJECTIVE: We used a novel technique, high-definition manometry (HDM) that utilizes 256 tactile sensitive microtransducers to define the characteristics of vaginal high-pressure zone. STUDY DESIGN: Sixteen nullipara asymptomatic women were studied using HDM, transperineal 2-dimensional dynamic ultrasound and dynamic magnetic resonance (MR) imaging. RESULTS: Vaginal high-pressure zone revealed higher contact ...

PURPOSE: The goal of this research was to study the chronic effects of pudendal nerve transection and sphincterotomy on the anal sphincter, because there is no good animal model investigating anal sphincter injury. Clinically, anal sphincter dysfunction impacts a cohort of women who have fecal incontinence; conclusions from the study ...

The purpose of this study was to investigate the influence of chin-down posture and bolus size on tongue pressure during swallowing. Eleven healthy volunteers (7 men, 4 women; age range = 26-59 years) participated in the experiments. Tongue pressure during dry and 5- and 15-ml water swallows in neutral and ...

The reasons for aspiration in healthy adults remain unknown. Given that the pharyngeal phase of swallowing is a key component of the safe swallow, it was hypothesized that healthy older adults who aspirate are likely to generate less pharyngeal peak pressures when swallowing. Accordingly, pharyngeal and upper esophageal sphincter pressures ...

BACKGROUND: The prevalence of obesity has increased dramatically in recent decades. The gastrointestinal changes associated with obesity have clinical significance for the anesthesiologist in the perioperative period. The lower esophageal sphincter and the upper esophageal sphincter play a central role in preventing regurgitation and aspiration. The effects of increased intra-abdominal ...

BACKGROUND AND AIMS: The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES, exposing it ...

OBJECTIVE: Anal acoustic reflectometry (AAR) is a new technique that offers an assessment of anal sphincter function by the measurement of additional parameters not available with conventional manometry. The aim of this study is to describe the technique, methodology and initial pilot study results. METHOD: Wideband sounds (100 Hz to ...

BACKGROUND & AIMS: Achalasia esophagus is characterized by loss of peristalsis and incomplete esophagogastric junction (EGJ) relaxation. We studied mechanisms of esophageal emptying in patients with achalasia using simultaneous high-resolution manometry, multiple intraluminal impedance, and high-frequency intraluminal ultrasonography image recordings. METHODS: Achalasia was categorized into 3 subtypes, based on the ...

OBJECTIVE: To evaluate anorectal function and rectal sensitivity thresholds in patients with celiac disease (CD). METHODS: In 25 unselected patients with CD (16 female, 9 male; mean age 45, range 24 to 75 y) and 20 controls (12 female, 8 male; mean age 41, range 20 to 65 y) anorectal ...

BACKGROUND: Secondary peristalsis is important for the clearance of retained food bolus or refluxate from the esophagus. Lidocaine has been used to evaluate the role of mucosa-mediating pathways of esophageal reflexes in animal model, but its effects on esophageal secondary peristalsis are yet unclear in humans. We aimed to investigate ...

Multipeaked waves (MPW) in the distal esophagus occur frequently in patients with esophageal spastic motor disorders and diabetes mellitus and are thought to represent repetitive esophageal contractions. We aimed to investigate whether the relative motion between a stationary pressure sensor and contracted peristaltic esophageal segment that moves with respiration leads ...

BACKGROUND: Although colonic manometry provides useful information regarding colonic physiology, considerable variability has been reported both for regional motility and manometric patterns. Whether colonic manometry is reproducible is not known. METHODS: Seven healthy volunteers (three men, four women, mean age = 34 years) underwent two studies of 24-h ambulatory colonic ...

OBJECTIVES: We quantified the effect of swallowing maneuvers on pharyngeal pressure events using high-resolution manometry. METHODS: Seven subjects swallowed multiple 5-mL water boluses in 3 different postural conditions: neutral, head turn, and chin tuck. Pressure and timing events were recorded with a 36-sensor high-resolution manometry catheter. We analyzed the regions ...

ABSTRACT Background: A subset of low-pressure fissure is not associated with typical internal anal sphincter hypertonia and may involve a different pathophysiological mechanism. We aimed to assess the manometric response of the internal anal sphincter to botulinum toxin in low compared to high pressure fissures. Method: Twenty five units of ...

SUMMARY Globus sensation is a bothersome and difficult symptom to treat. The aims of this study were to evaluate the acceptability and utility of hypnotically-assisted relaxation (HAR) in decreasing the perception of globus sensation and the effect of HAR on interdeglutitive upper esophageal sphincter (UES) pressure. Sixteen subjects with persistent ...

Although some studies show that the upper esophageal sphincter (UES) contracts during transient lower esophageal sphincter relaxation (TLESR), others show that it relaxes. We hypothesized that the posture of the subject and constituents of gastroesophageal reflux (GER) may determine the type of UES response during the TLESR. High-resolution manometry and ...

PURPOSE: Chemical sphincterotomy (CS) is routinely applied in order to avoid the irreversible anal incontinence associated with the surgical treatment of chronic anal fissure (CAF). However, CS has a lower cure rate than surgery. We developed a screening test (using anal manometry) to separate those patients that are unlikely to ...

The concept of high-resolution manometry (HRM) is to use sufficient pressure sensors such that intraluminal pressure can be monitored as a continuum along luminal length much as time is viewed as a continuum in conventional manometry. When HRM is coupled with pressure topography plots, pressure amplitude is transformed into spectral ...

The aim of the present study was to determine whether acid perfusion into the distal esophagus causes a globus sensation and an increase in upper esophageal sphincter (UES) pressure. UES pressures were measured using a sleeve-type sensor in 20 healthy volunteers. A 0.1-N HCl solution, the same as gastric acid, ...

BACKGROUND: Guide wires are commonly utilized to facilitate endoscopic procedures. However, their use may adversely influence the results of sphincter of Oddi manometry, thereby leading to erroneous diagnosis and therapy. The aim of this study was to evaluate the effect of guide wires on the basal pressure of the biliary ...

BACKGROUND: Gastroesophageal reflux (GER) is thought to be induced by decreasing intraesophageal pressure during obstructive sleep apnea (OSA). However, pressure changes in the upper esophageal sphincter (UES) and gastroesophageal junction (GEJ) pressure during OSA events have not been measured. The aim of this study was to determine UES and GEJ ...

PURPOSE: The purpose of this study was to evaluate the short-term preoperative effects of neoadjuvant chemoradiation on anorectal function, excluding the bias of postoperative impairment. METHODS: We analyzed 80 patients on whom preoperative anorectal manometry data were available for both prechemoradiation and postchemoradiation. Patients were divided into 2 groups according ...

BACKGROUND: Rumination is an eating disorder clinically suspected in the presence of chronic regurgitation of recently ingested food with subsequent re-mastication and swallowing. Oesophageal manometry is currently used to confirm the diagnosis, however, it is difficult to distinguish rumination from postprandial belching-regurgitation, being the manometric pattern identical in both situations. ...

BACKGROUND: This study aimed to correlate oesophageal bolus transit with features of oesophageal pressure topography (OPT) plots and establish OPT metrics for accurately measuring peristaltic velocity. METHODS: About 18 subjects underwent concurrent OPT and fluoroscopy studies. The deglutitive Contractile Front Velocity (CFV) in OPT plots was subdivided into an initial ...

Three-dimensional scaled-up transparent models of three human cystic ducts were prepared on the basis of anatomical specimens. The measurement of pressure drop across the cystic duct models and visualization of the flow structures within these ducts were performed at conditions replicating the physiological state. The flow visualization study confirmed the ...

OBJECTIVE: Restorative proctectomy with straight coloanal anastomosis (CAA) and restorative proctocolectomy with ilealpouch-anal anastomosis (IPAA) are options for maintaining bowel integrity after rectal resection. The aim of this study was to compare clinical function and anorectal physiology in patients treated with CAA and IPAA. METHOD: Three-dimensional vector-manometry and neorectal volumetry ...

ABSTRACT Aim: Faecal incontinence is commonly seen in patients with internal rectal prolapse, though the mechanism is not clear. This study assessed the relationship between internal rectal prolapse and anal sphincter function. Methods: Patients with both internal rectal prolapse diagnosed on proctography and those with external rectal prolapse were identified ...

Anorectal manometry provides an objective assessment of anal sphincter pressure and rectal sensitivity and anorectal reflexes in response to distension. However, its clinical utility is hampered by a lack of standardized protocols and normative data from healthy subjects. Previous studies have used water-perfused systems in normal subjects, but some adopted ...

BACKGROUND: The success of natural orifice surgery depends on a reliable, secure closure of the opening in the gut. Forces that might be exerted on the gastric wall to disrupt closure have not been measured in humans or animals. OBJECTIVE: To determine how transmural gastric pressure gradients vary under different ...

OBJECTIVE: Ginger has been traditionally used to reduce intestinal gas and flatulence. The present study examined the effects of ginger on the esophagus and lower esophageal sphincter (LES) function by esophageal manometry. STUDY DESIGN: A randomized controlled trial. SETTING: Departments of Physiology and Medicine, Faculty of Medicine Siriraj Hospital. SUBJECTS: ...

We sought to derive compliance curves of the trachea and esophagus. 16 fresh human cadavers were intubated tracheally and esophageally and cuff pressures measured at equal air volumes. Tracheal compliance was statistically less than esophageal compliance for volumes of 1, 2, and 3 mL of air, (p = 0.002, p ...

AIM: To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possible relationship with gastro-esophageal reflux disease. METHODS: Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four ...

OBJECTIVES: This study aimed to quantify the effects of head rotation on upper esophageal sphincter (UES) pressure in healthy subjects using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Prospective study. SETTING: Nagasaki University Hospital. SUBJECTS AND METHODS: Eighteen asymptomatic Japanese male adult volunteers were studied. A solid-state HRM was ...

OBJECTIVE: The aim of the study was to compare the esophagogastric junction (EGJ) compliance in response to controlled distension in fundoplication (FP) patients and controls using the functional luminal imaging probe (FLIP). BACKGROUND: FP aims to replicate normal EGJ distensibility. FLIP is a new technology that uses impedance planimetry to ...

Aim: The increased use of transanal colonic irrigation (TAI) warrants study of its effects on anorectal function after long term use. Method: Anorectal physiology tests were performed in 12 patients with chronic idiopathic constipation (CC) and 10 with idiopathic faecal incontinence (FI) (median 55 years (range 21-70)) before and after ...

BACKGROUND: Many anesthetics reduce lower esophageal sphincter pressure (LESP). Reduced pressure and consequent reduction in the gastroesophageal pressure gradient (GEPG) thus promotes gastroesophageal reflux and may contribute to aspiration pneumonia and associated morbidity. Therefore, the authors compared LESP and GEPG during dexmedetomidine and propofol sedation. METHODS: Using a randomized, double-blind, ...

This study aimed to assess the relationship between nadir lower oesophageal sphincter pressure (LOSP) and wave amplitude (WA) in oesophageal bolus clearance. Concurrent oesophageal manometry and impedance were performed in 146 subjects [41 healthy, 24 non-obstructive dysphagia (NOD) and 81 gastro-oesophageal reflux (GOR)]. Patients with achalasia and diffuse oesophageal spasm ...

Purpose. To determine intragastric pressure threshold for inducing gastroesophageal junction (GEJ) opening in normal control subjects with and without hiatal hernia, and in patients with gastroesophageal reflux disease. Methods. This study was performed in 13 normal volunteers, 5 volunteers with hiatal hernia, and 3 patients with gastroesophageal reflux disease. During ...

BACKGROUND: Our aim was to assess pressure dynamics within the esophagogastric junction (EGJ) in sliding hiatus hernia (HH) during normal peristalsis and to compare the pressure profiles of HH patients with gastroesophageal reflux disease (GERD) symptoms (HH-GERD) to HH patients with dysphagia (HH-dysphagia). METHODS: High-resolution manometry studies in 230 consecutive ...

Relationships of regional colonic motility to transit in health, constipation, and constipation-predominant irritable bowel syndrome (C-IBS) are poorly characterized. This study aimed to 1) characterize regional differences in colon pressure, 2) relate motor differences in constipation to colon transit, and 3) quantify the role of IBS in altered contractility with ...

OBJECTIVE: We tested whether gastro-oesophageal pressure gradient is augmented in sliding hiatal hernia and the yield of oesophageal manometry in diagnosing sliding hiatal hernia. METHODS: Patients with equivalent body mass index were categorised according to manometry and endoscopy in groups: (1) no sliding hiatal hernia (n=147); (2) sliding hiatal hernia ...

In conducting clinical high-resolution oesophageal pressure topography (HROPT) studies we observed that after subjects sat upright between series of supine and upright test swallows, they frequently had a transient lower oesophageal sphincter relaxation (TLOSR). When achalasia patients were studied in the same protocol, they exhibited a similar HROPT event leading ...