| Esophageal motor disorders in terms of high-resolution esophageal pressure topography: what has changed? | |
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MedLine Citation:
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PMID: 20179690 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 colors with isobaric conditions indicated by same-colored regions on the display. Together, these technologies are called high-resolution esophageal pressure topography (HREPT). HREPT has several advantages compared with conventional manometry, the technology that it was designed to replace. (i) The contractility of the entire esophagus can be viewed simultaneously in a uniform format, (ii) standardized objective metrics can be systematically applied for interpretation, and (iii) topographic patterns of contractility are more easily recognized and have greater reproducibility than with conventional manometry. Compared with conventional manometry, HREPT has improved sensitivity for detecting achalasia, largely due to the objectivity and accuracy with which it identifies impaired esophagogastric junction (EGJ) relaxation. In addition, it has led to the subcategorization of achalasia into three clinically relevant subtypes based on the contractile function of the esophageal body: classic achalasia, achalasia with esophageal compression, and spastic achalasia. Headway has also been made in understanding hypercontractile conditions, including diffuse esophageal spasm and a newly described entity, spastic nutcracker. Ultimately, clinical experience will be the judge, but it seems likely that HREPT data, along with its well-defined functional implications, will improve the clinical management of esophageal motility disorders. |
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Authors:
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Peter J Kahrilas |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Review Date: 2010-02-23 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 105 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-06 Completed Date: 2010-06-02 Revised Date: 2010-12-03 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 981-7 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611-2951, USA. p-kahrilas@northwestern.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Esophageal Achalasia
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diagnosis Esophageal Motility Disorders / diagnosis* Esophagogastric Junction / physiopathology* Esophagoscopy / methods Female Gastroesophageal Reflux / diagnosis Humans Image Processing, Computer-Assisted / methods* Male Manometry / methods* Pressure Sensitivity and Specificity |
| Grant Support | |
ID/Acronym/Agency:
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R01 DK056033-09/DK/NIDDK NIH HHS; R01 DK56033/DK/NIDDK NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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