| Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation. | |
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MedLine Citation:
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PMID: 19174789 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Although globus sensation is a common symptom, its pathogenesis is poorly defined. The aim of this study was to quantify the timing and magnitude of respiratory variation in upper esophageal sphincter (UES) pressure with high-resolution manometry (HRM) in patients with globus sensation, normal controls, and gastroesophageal reflux disease (GERD) patients without globus sensation. METHODS: HRM recordings spanning from the hypopharynx to the stomach were analyzed in 131 consecutive globus patients with normal (64) and abnormal (67) distal esophageal motility. Resting UES pressure was analyzed up to 5 min before 10 5-ml water swallows. Change in UES pressure, its average magnitude between inspiration and expiration, and nadir UES relaxation pressure in globus patients were compared with those in 68 controls and 46 GERD patients without globus. RESULTS: UES pressure typically increased during inspiration in both controls and patients. Respiration-related change in resting UES pressure was significantly amplified in globus patients (37.3 mm Hg) compared with controls (10.6 mm Hg) and GERD patients (13.0 mm Hg) (P<0.0001). A respiratory change in UES pressure>27 mm Hg was found in >60% of globus patients and <15% of controls and GERD patients without globus. This hyperdynamic UES was not associated with other abnormalities of esophageal motor function. CONCLUSIONS: Hyperdynamic respiratory UES pressure changes were prevalent in patients reporting globus sensation irrespective of their deglutitive UES and distal esophageal motility. Although the etiology of this hyperdynamic UES is unclear, it does appear to be a frequent manometric observation in this patient group and may provide a new focus for further studies into pathogenesis and therapy. |
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Authors:
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Monika A Kwiatek; Faiz Mirza; Peter J Kahrilas; John E Pandolfino |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-01-20 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 104 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-04 Completed Date: 2009-03-03 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: 289-98 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. monika.kwiatek@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Case-Control Studies Esophageal Sphincter, Upper / physiopathology* Exhalation / physiology Female Gastroesophageal Reflux / complications, physiopathology Humans Inhalation / physiology Male Manometry Middle Aged Muscle Relaxation / physiology Pressure* Somatosensory Disorders / complications, physiopathology* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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K23 DK062170-01/DK/NIDDK NIH HHS; R01 DC000646-09/DC/NIDCD NIH HHS; R01 DC00646/DC/NIDCD NIH HHS |
| Comments/Corrections | |
Comment In:
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Gastroenterology. 2009 Nov;137(5):1847-9
[PMID:
19789084
]
Am J Gastroenterol. 2009 Feb;104(2):299-301 [PMID: 19190607 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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