Document Detail

Measuring movement and location of the gastroesophageal junction: research and clinical implications.
MedLine Citation:
PMID:  23205940     Owner:  NLM     Status:  MEDLINE    
Understanding the physiology of gastroesophageal junction (GEJ) is important as failure of its function is associated with reflux disease, hiatus hernia, and cancer. In recent years, there have been impressive developments in high resolution technologies allowing measurement of luminal pressure, pH, and impedance. One obvious deficiency is the lack of technique to monitor the movement and location of the GEJ over a prolonged period of time. Proximal movement of the GEJ during peristalsis and transient lower esophageal sphincter relaxations (TLESRs) is due to shortening of the longitudinal muscle of the esophagus. Techniques for measuring shortening include fluoroscopic imaging of mucosal clip, high-frequency intraluminal ultrasound, and high resolution manometry, but these techniques have limitations. Short segment reflux is recently found to be more common than traditional reflux and may account for the high prevalence of intestinal metaplasia and cancer seen at GEJ. While high resolution pHmetry is available, there is no technique that can reliably and continuously measure the position of the squamocolumnar junction. A new technique is recently reported allowing a precise and continuous measurement of the GEJ based on the principle of Hall effect. Reported studies have validated its accuracy both on the bench and against the gold standard, fluoroscopy. It has been used alongside high resolution manometry in studying the behavior of the GEJ during TLESRs and swallows. While there are challenges associated with this new technique, there are promising ongoing developments. There is exciting time ahead in research and clinical applications for this new technique.
Yeong Yeh Lee; James G H Whiting; Elaine V Robertson; Mohammad H Derakhshan; Donald Smith; Kenneth E L McColl
Publication Detail:
Type:  Journal Article; Review     Date:  2012-12-04
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  48     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-22     Completed Date:  2013-11-19     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  401-11     Citation Subset:  IM    
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MeSH Terms
Body Composition
Electric Impedance
Esophagogastric Junction / pathology,  physiology*,  physiopathology
Fluoroscopy / methods
Gastroesophageal Reflux / physiopathology
Hernia, Hiatal / physiopathology
Hydrogen-Ion Concentration
Monitoring, Physiologic
Neoplasms / physiopathology
Reproducibility of Results
Grant Support
CZB/4/709//Chief Scientist Office

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

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