Document Detail


Mechanical properties of the esophagus in eosinophilic esophagitis.
MedLine Citation:
PMID:  20858491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: This study aimed to analyze the mechanical properties of the esophagus in eosinophilic esophagitis (EoE) using the functional luminal imaging probe (EndoFLIP; Crospon Medical Devices, Galway, Ireland).
METHODS: Thirty-three EoE patients (22 male; age range, 23-67 years) and 15 controls (6 male; age range, 21-68 years) were included. Subjects were evaluated during endoscopy with the EndoFLIP probe, comprised of a compliant cylindrical bag (maximal diameter 25 mm) with 16 impedance planimetry segments. Stepwise bag distensions from 2 to 40 mL were conducted and the associated intrabag pressure and intraluminal geometry were analyzed.
RESULTS: The EndoFLIP clearly displayed the tubular esophageal geometry and detected esophageal narrowing and localized strictures. Stepwise distension progressively opened the esophageal lumen until a distension plateau was reached such that the narrowest cross-sectional area (CSA) of the esophagus maximized despite further increases in intra-bag pressure. The esophageal distensibility (CSA vs pressure) was reduced in EoE patients (P = .02) with the distension plateau of EoE patients substantially lower than that of controls (median: CSA 267 mm(2) vs 438 mm(2); P < .01). Mucosal eosinophil count, age, sex, and current proton pump inhibitor treatment did not predict this limiting caliber of the esophagus (P ≥ 0.20).
CONCLUSIONS: Esophageal distensibility, defined by the change in the narrowest measurable CSA within the distal esophagus vs intraluminal pressure was significantly reduced in EoE patients compared with controls. Measuring esophageal distensibility may be an important adjunct to the management of EoE, as it is capable of providing an objective means to measure the outcomes of medical or dilation therapy.
Authors:
Monika A Kwiatek; Ikuo Hirano; Peter J Kahrilas; Jami Rothe; Daniel Luger; John E Pandolfino
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-09-19
Journal Detail:
Title:  Gastroenterology     Volume:  140     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  2011-01-20     Revised Date:  2012-01-04    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  82-90     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611-2951, USA. monika.kwiatek@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chest Pain / diagnosis,  physiopathology
Dilatation
Endoscopy, Gastrointestinal / instrumentation,  methods
Eosinophilic Esophagitis / physiopathology*
Esophageal Stenosis / diagnosis
Esophagus / physiopathology*
Female
Humans
Male
Mechanical Processes
Middle Aged
Young Adult
Grant Support
ID/Acronym/Agency:
R01 DK056033-09/DK/NIDDK NIH HHS; R01 DK079902/DK/NIDDK NIH HHS; R01 DK079902-02/DK/NIDDK NIH HHS; R01 DK079902-03/DK/NIDDK NIH HHS; R01 DK56033/DK/NIDDK NIH HHS

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


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