Document Detail


Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation.
MedLine Citation:
PMID:  19174789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Monika A Kwiatek; Faiz Mirza; Peter J Kahrilas; John E Pandolfino
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-01-20
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  104     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-04     Completed Date:  2009-03-03     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-98     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. monika.kwiatek@gmail.com
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MeSH Terms
Descriptor/Qualifier:
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:
K23 DK062170-01/DK/NIDDK NIH HHS; R01 DC000646-09/DC/NIDCD NIH HHS; R01 DC00646/DC/NIDCD NIH HHS
Comments/Corrections
Comment In:
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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