Document Detail

High-resolution manometry and impedance-pH/manometry: valuable tools in clinical and investigational esophagology.
MedLine Citation:
PMID:  18639550     Owner:  NLM     Status:  MEDLINE    
Both high-resolution manometry (HRM) and impedance-pH/manometry monitoring have established themselves as research tools and both are now emerging in the clinical arena. Solid-state HRM capable of simultaneously monitoring the entire pressure profile from the pharynx to the stomach along with pressure topography plotting represents an evolution in esophageal manometry. Two strengths of HRM with pressure topography plots compared with conventional manometric recordings are (1) accurately delineating and tracking the movement of functionally defined contractile elements of the esophagus and its sphincters, and (2) easily distinguishing between luminal pressurization attributable to spastic contractions and that resultant from a trapped bolus in a dysfunctional esophagus. Making these distinctions objectifies the identification of achalasia, distal esophageal spasm, functional obstruction, and subtypes thereof. Ambulatory intraluminal impedance pH monitoring has opened our eyes to the trafficking of much more than acid reflux through the esophageal lumen. It is clear that acid reflux as identified by a conventional pH electrode represents only a subset of reflux events with many more reflux episodes being composed of less acidic and gaseous mixtures. This has prompted many investigations into the genesis of refractory reflux symptoms. However, with both technologies, the challenge has been to make sense of the vastly expanded datasets. At the very least, HRM is a major technological tweak on conventional manometry, and impedance pH monitoring yields information above and beyond that gained from conventional pH monitoring studies. Ultimately, however, both technologies will be strengthened as outcome studies evaluating their utilization become available.
Peter J Kahrilas; Daniel Sifrim
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2008-07-17
Journal Detail:
Title:  Gastroenterology     Volume:  135     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-15     Completed Date:  2008-10-02     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  756-69     Citation Subset:  AIM; IM    
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MeSH Terms
Esophageal Motility Disorders / diagnosis
Esophageal Sphincter, Lower / physiopathology
Esophageal pH Monitoring*
Esophagus / physiopathology*
Gastroesophageal Reflux / physiopathology
Manometry* / methods
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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