Document Detail


High-resolution manometry in clinical practice: utilizing pressure topography to classify oesophageal motility abnormalities.
MedLine Citation:
PMID:  19413684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-resolution manometry capable of pressure monitoring from the pharynx to the stomach together with pressure topography plotting represents an unquestionable evolution in oesophageal manometry. However, with this advanced technology come challenges and one of those is devising the optimal scheme to apply high-resolution oesophageal pressure topography (HROPT) to the clinical evaluation of patients. The first iteration of the Chicago classification was based on a systematic analysis of motility patterns in 75 control subjects and 400 consecutive patients. This review summarizes the analysis process as it has evolved. Individual swallows are analysed in a stepwise fashion for the morphology of the oesophagogastric junction (OGJ), the extent of OGJ relaxation, the propagation velocity of peristalsis, the vigour of the peristaltic contraction, and abnormalities of intrabolus pressure utilizing metrics that have now been customized to HROPT. These results are then synthesized into a comprehensive diagnosis that, although based on conventional manometry criteria, is also customized to HROPT measures. The resultant classification objectifies the identification of three unique subtypes of achalasia. Additionally, it provides enhanced detail in the description of distal oesophageal spasm, nutcracker oesophagus subtypes, and OGJ obstruction. It is our expectation that modification of this classification scheme will continue to occur and this should further clarify the utility of pressure topography plotting in assessing oesophageal motility disorders.
Authors:
J E Pandolfino; M R Fox; A J Bredenoord; P J Kahrilas
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2009-04-22
Journal Detail:
Title:  Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society     Volume:  21     ISSN:  1365-2982     ISO Abbreviation:  Neurogastroenterol. Motil.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-23     Completed Date:  2009-10-30     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  9432572     Medline TA:  Neurogastroenterol Motil     Country:  England    
Other Details:
Languages:  eng     Pagination:  796-806     Citation Subset:  IM    
Affiliation:
Department of Medicine, Northwestern University, Chicago, IL 60611-2951, USA. j-pandolfino@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Deglutition
Esophageal Motility Disorders* / classification,  diagnosis
Humans
Manometry / methods*
Pressure
Grant Support
ID/Acronym/Agency:
R01 DC000646-09/DC/NIDCD NIH HHS; R01 DC00646/DC/NIDCD NIH HHS
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