Lower Esophageal Sphincter Efficacy Following Laparoscopic Antireflux Surgery with Hiatal Repair: Role of Fluoroscopy, High-Resolution Impedance Manometry and FLIP in Detecting Recurrence of GERD and Hiatal Hernia

2017 ◽  
pp. 153-168
Author(s):  
Vivien Wong ◽  
Barry McMahon ◽  
Hans Gregersen
Keyword(s):  
High Resolution ◽  
Hiatal Hernia ◽  
Lower Esophageal Sphincter ◽  
Antireflux Surgery ◽  
Laparoscopic Antireflux Surgery ◽  
Esophageal Sphincter ◽  
Hiatal Repair

The role of the lower esophageal sphincter and hiatal hernia in the pathogenesis of gastroesophageal reflux disease

1998 ◽  
Vol 114 ◽  
pp. A1419
Author(s):  
M. Fein ◽  
M.P. Ritter ◽  
T.R. DeMeester ◽  
J.H. Peters ◽  
S. Öberg ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Lower Esophageal Sphincter ◽  
Reflux Disease ◽  
Esophageal Sphincter

High Resolution Manometry and pH stepup method on the localisation of the lower esophageal sphincter

2017 ◽  
Vol 26 (4) ◽  
pp. 425-429
Author(s):  
Atte Haarala ◽  
Juli-Anna Linjamäki ◽  
Heikki Tuominen ◽  
Mika Kähönen
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

.

scholarly journals Physiological and pathological roles of the accommodation response in lower esophageal sphincter relaxation during wet swallows

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Muta ◽  
Eikichi Ihara ◽  
Shohei Hamada ◽  
Hiroko Ikeda ◽  
Masafumi Wada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Relaxation Function ◽  
Esophagogastric Junction ◽  
Prospective Observational Study ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

AbstractThe preparatory accommodation response of lower esophageal sphincter (LES) before swallowing is one of the mechanisms involved in LES relaxation during wet swallows, however, the physiological and/or pathological roles of LES accommodation remain to be determined in humans. To address this problem, we conducted a prospective observational study of 38 patients with normal high-resolution manometry (HRM) and 23 patients with idiopathic esophagogastric junction outflow obstruction (EGJOO) to assess dry and wet swallows. The LES accommodation measurement was proposed for practical use in evaluating the LES accommodation response. Although swallow-induced LES relaxation was observed in both dry and wet swallows, LES accommodation (6.4, 3.1–11.1 mmHg) was only observed in wet swallows. The extent of LES accommodation was impaired in idiopathic EGJOO (0.6, − 0.6–6 mmHg), and the LES accommodation measurement of patients with idiopathic EGJOO (36.8, 29.5–44.3 mmHg) was significantly higher in comparison to those with normal HRM (23.8, 18–28.6 mmHg). Successful LES relaxation in wet swallowing can be achieved by LES accommodation in combination with swallow-induced LES relaxation. Impaired LES accommodation is characteristic of idiopathic EGJOO. In addition to the IRP value, the LES accommodation measurement may be useful for evaluating the LES relaxation function in clinical practice.

Sa1327 High-Resolution Manometry Assessment of the Lower-Esophageal Sphincter Aftercontraction: Normative Values and Clinical Significance

2016 ◽  
Vol 150 (4) ◽  
pp. S283-S284
Author(s):  
Dustin A. Carlson ◽  
Peter Kahrilas ◽  
Zoe Listernick ◽  
Yinglian Xiao ◽  
Vadim Bul ◽  
...  
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Clinical Significance ◽  
Normative Values ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

PS01.008: LOWER ESOPHAGEAL SPHINCTER PRESSURE (LESP) AS A MEASURE OF ANTI-REFLUX BARRIER IN PATIENTS WITH HIATUS HERNIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 51-52
Author(s):  
Balazs Kovacs ◽  
Takahiro Masuda ◽  
Ross Bremner ◽  
Sumeet Mittal
Keyword(s):  
Hiatal Hernia ◽  
Lower Esophageal Sphincter ◽  
Hiatus Hernia ◽  
Conflicts Of Interest ◽  
Holding Time ◽  
Sphincter Pressure ◽  
Total Acid ◽  
Inversion Point ◽  
Type C ◽  
Esophageal Sphincter

Abstract Background Hiatus Hernia (HH), with its anatomical/physiological derangement of esophagogastric junction (EGJ) barrier function is a risk factor for pathological gastro-esophageal reflux (GER). However, a subset of patients with HH do not have reflux. The aim of this study is to explore Lower Esophageal sphincter parameters and GER across the EGJ in patients with manometeric type C hiatal hernia (LES-Crural Diaphragm separation > 1cm, and Pressure Inversion Point below LES). Methods An IRB approved, prospectively maintained esophageal testing registry was queried to identify patients who underwent High Resolution Manometry and 24h pH study (within 1 week) between 11/01/2016 and 11/01/2017. HRM characteristics of the EGJ (LES-CD separation, overall length, LESP, LESPI), 24 hour pH score, and pH < 4 holding time were extracted. Spearman's Rho correlation was calculated for all parameters and Receiver operating characteristic (ROC) curve was applied for parameters with significant correlation. Results A total of 1139 patients underwent HRM during the study period, of these 416 also had 24 hour pH study. 76 Patients met criteria for EGJ morphology Type C. After excluding patients with major disorders of peristalsis (16) the remaining 60 patients form the cohort of this study. Hiatal hernia size, overall length of LES, and LESPI did not correlate with 24 hour pH score or pH < 4 holding time. LESP had a significant negative correlation both with 24 hour pH score (R: -0.322; P = 0.011), and total acid holding time (R: -0.348; P = 0.006). A LESP cut-off value of 24.4 mmHg had a sensitivity of 53.8% and a Specificity of 91.2% for predicting pathological reflux. Conclusion A higher LESP (> 24.4 mmHg) appears to provide an effective barrier to pathological GER even when normal EGJ function is compromised by a hiatal hernia. Disclosure All authors have declared no conflicts of interest.

Sign in / Sign up

Export Citation Format

Share Document