| Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. | |
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MedLine Citation:
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PMID: 17490156 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Purpose Distal oesophageal ramp pressure upon swallowing results from resistance from the oesophago-gastric junction below and pressure from above (peristaltic wave) with pressure build-up in the distal oesophagus. Ramps are observed during manometry, but the factors which influence the magnitude of ramp pressure have not been elucidated. This study aims to establish the normal range for ramp pressures and ascertain manometric and anatomic features which affect ramp pressure, in order to study ramp pressures and dysphagia following antireflux surgery. Methodology A standard 8 channel motility catheter with a sleeve was used with a water perfused manometry system, to record the ramps at 3 cm above the lower oesophageal sphincter (LOS) associated with ten 5 mL water swallows. Results 614 water swallows (5 mL) have been analysed in 68 subjects: 20 controls, 25 reflux patients and 23 patients after a partial (12) or total (11) fundoplication. Control patients had LOS of 17 +/- 0.4 mmHg, relaxation pressure of 1.4 +/- 0.2 mmHg and a ramp of 8 +/- 0.3 mmHg (mean +/- std error). Reflux patients had significantly lower pressures than controls for all parameters studied. As expected after anti-reflux surgery, all pressures were significantly higher with total fundoplication producing the highest pressures. The ramp pressure after total fundoplication was 22 +/- 0.6 mmHg and after partial fundoplication was 15 +/- 0.5 mmHg. Conclusions Ramp pressure integrates the distal peristaltic amplitude with lower oesophageal resistance to outflow. It is possible that lower rates of dysphagia after partial fundoplication are associated with lower ramp pressures. However the relationship between ramp pressure and dysphagia remains to be elucidated. |
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Authors:
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J C Myers; G G Jamieson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: ANZ journal of surgery Volume: 77 Suppl 1 ISSN: 1445-1433 ISO Abbreviation: - Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-05-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101086634 Medline TA: ANZ J Surg Country: Australia |
Other Details:
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Languages: eng Pagination: A43 Citation Subset: IM |
Affiliation:
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University of Adelaide, South Australia, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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