scholarly journals Adequate Number of Swallows for Pharyngeal Pressure Measurement of a Subject using High-resolution Manometry

2020 ◽  
Author(s):  
Matsusato Tsuyumu ◽  
Takanori Hama ◽  
Takakuni Kato ◽  
Hiromi Kojima
Keyword(s):  
High Resolution ◽  
Major Change ◽  
Upper Esophageal Sphincter ◽  
Rate Of Change ◽  
Sphincter Pressure ◽  
High Resolution Manometry ◽  
Average Value ◽  
Pharyngeal Pressure ◽  
Single Person ◽  
The Mean

Abstract Introduction The number of pressure measurements that need to be recorded using high-resolution manometry (HRM) for the accurate evaluation of pharyngeal function is not well established. Objective The purpose of this study is to clarify the number of swallows required to obtain an accurate pharyngeal manometric profile of a person. Methods Forty healthy adults performed a dry swallow and bolus swallows using 3-, 5-, or 10 ml of water and underwent measurements using the Starlet HRM system. Each subject underwent 10 swallows for each of the four bolus volume conditions. Results The mean of up to seven measurements of maximum pre-swallow upper esophageal sphincter pressure with 10 ml of swallow was close to the mean of up to eight measurements in 95% of the subjects. Similarly, the rate of change of the average for the eighth and ninth measurements and the rate of change for the average of the ninth and tenth measurements were less than 5%. When the other parameters were similarly measured up to the sixth measurement, no major change in the average value was observed even if more measurements were taken. Conclusion A minimum of six measurements are required, and seven swallows are sufficient for evaluating the pharyngeal manometric profile of a single person. This number of measurements can be a useful criterion when performing HRM measurements on individual subjects.

PS01.009: COMPREHENSIVE CLASSIFICATION FOR ANTIREFLUX FUNCTION OF THE ESOPHAGOGASTRIC JUNCTION BASED ON HIGH-RESOLUTION MANOMETRY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 52-52
Author(s):  
Takahiro Masuda ◽  
Balazs Kovacs ◽  
Ross Bremner ◽  
Sumeet Mittal
Keyword(s):  
High Resolution ◽  
Esophagogastric Junction ◽  
Conflicts Of Interest ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Total Acid ◽  
High Resolution Manometry ◽  
Demeester Score ◽  
Cumulative Score ◽  
The Mean

Abstract Background The anatomical configuration of the esophagogastric junction (EGJ) and the thoracoabdominal pressure gradient (TAPG) affect gastric content backflow into the esophagus. A comprehensive antireflux function assessment is needed to identify underlying derangements in patients with gastroesophageal reflux (GER). Herein we propose an objective scoring system for grading EGJ function. Methods We analyzed patients who underwent 24-hour pH study and high-resolution manometry in 2017 at our institution. We assessed three factors: EGJ morphology, lower esophageal sphincter pressure integral, and TAPG. Each factor was scored on a scale of 0–2, and a cumulative score was calculated (Table 1). Patients were divided into 3 groups based on cumulative score: 0, competent EGJ function (Grade I); 1–3, moderate incompetency (Grade II); 4–6, poor competency (Grade III). Results In total, 140 patients were studied. The mean age was 58.6 years, 75 patients (53.6%) were men, and the mean body mass index was 28.6 kg/m2. Fifty-one patients (36.4%) had an abnormal DeMeester score (ie, > 14.72). A significant, progressive increase was seen in number of reflux episodes (I-25.7, II-36.4, III-50.5, rs = 0.207, P = 0.015), total acid exposure time (I-1.0%, II-2.1%, III-5.0%, rs = 0.312, P < 0.001) and prevalence of abnormal pH score (I-13.0%, II-32.0%, III-57.1%, rs = 0.314, P < 0.001) from Grade I to III. Conclusion The proposed grading of the EGJ based on a cumulative score of individual parameters has a good correlation with GER. Disclosure All authors have declared no conflicts of interest.

scholarly journals Upper esophageal sphincter resting pressure varies during esophageal manometry

2014 ◽  
Vol 27 (3) ◽  
pp. 182-183 ◽  
Author(s):  
Daniel Tavares REZENDE ◽  
Fernando A. M. HERBELLA ◽  
Luciana C. SILVA ◽  
Sebastião PANOCCHIA-NETO ◽  
Marco G. PATTI
Keyword(s):  
High Resolution ◽  
Esophageal Manometry ◽  
Striated Muscle ◽  
Upper Esophageal Sphincter ◽  
Standard Test ◽  
Sphincter Pressure ◽  
High Resolution Manometry ◽  
Basal Pressure ◽  
Resting Pressure ◽  
Esophageal Sphincter

BACKGROUND: The upper esophageal sphincter is composed of striated muscle. The stress of intubation and the need to inhibit dry swallows during an esophageal manometry test may lead to variations in basal pressure of this sphincter. Upper esophageal sphincter is usually only studied at the final part of the test. Was observed during the performance of high resolution manometry that sphincter pressure may vary significantly over the course of the test. AIM: To evaluate the variation of the resting pressure of the upper esophageal sphincter during high resolution manometry. METHODS: Was evaluated the variation of the basal pressure of the upper esophageal sphincter during high resolution manometry. Were reviewed the high resolution manometry tests of 36 healthy volunteers (mean age 31 years, 55% females). The basal pressure of the upper esophageal sphincter was measured at the beginning and at the end of a standard test. RESULTS: The mean time of the test was eight minutes. The basal pressure of the upper esophageal sphincter was 100 mmHg at the beginning of the test and 70 mmHg at the end (p<0.001). At the beginning, one patient had hypotonic upper esophageal sphincter and 14 hypertonic. At the end of the test, one patient had hypotonic upper esophageal sphincter (same patient as the beginning) and seven hypertonic upper esophageal sphincter. CONCLUSION: A significant variation of the basal pressure of the upper esophageal sphincter was observed in the course of high resolution manometry. Probably, the value obtained at the end of the test may be more clinically relevant.

S119 – Tongue-holding Maneuver Studied by High-resolution Manometry

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P117-P117
Author(s):  
Hiroshi Umeki ◽  
Kenji Takasaki ◽  
Kaori Enatsu ◽  
Fujinobu Tanaka ◽  
Hidetaka Kumagami ◽  
...  
Keyword(s):  
Standard Deviation ◽  
High Resolution ◽  
Mean Value ◽  
Upper Esophageal Sphincter ◽  
Mean Values ◽  
High Resolution Manometry ◽  
Maximum Value ◽  
Asymptomatic Adult ◽  
The Mean ◽  
Esophageal Sphincter

Objectives This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing, using a novel high-resolution manometry (HRM) system. Methods 27 asymptomatic adult Japanese controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the dry swallowing pressures at meso-hypopharynx, the upper esophageal sphincter (UES) and the mean values at meso-hypopharynx with and without THM were measured. Results The maximum values of dry swallowing pressures with and without THM were 195.0±77.2 (mmHg, mean ± standard deviation), and 178.1±53.0 at the meso-hypopharynx, and 213.4±74.0 and 190.0±95.0 at the UES, respectively. The mean values with and without THM at meso-hypopharynx were 47.4±11.9, and 44.0±11.2, respectively. The maximum value at UES (p=0.0347), and the mean value at the meso-hypopharynx (p=0.0124) of dry swallowing pressures with THM were significantly higher than those without THM. Conclusions These findings indicate that the THM has a potential to facilitate compensatory swallowing power at the pharynx and upper esophagus. HRM will provide us with important information about the swallowing physiology, and pathophysiology along the velopharynx, and upper esophagus.

The upper esophageal sphincter in the high-resolution manometry era

2021 ◽  
Author(s):  
Pedro Norton ◽  
Fernando A. M. Herbella ◽  
Francisco Schlottmann ◽  
Marco G. Patti
Keyword(s):  
High Resolution ◽  
Upper Esophageal Sphincter ◽  
High Resolution Manometry ◽  
Esophageal Sphincter

scholarly journals Comparison of Anorectal Function Measured using Wearable Digital Manometry and a High Resolution Manometry System

2020 ◽  
Author(s):  
Ali Attari ◽  
William D. Chey ◽  
Jason R. Baker ◽  
James A. Ashton-Miller
Keyword(s):  
High Resolution ◽  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Chronic Constipation ◽  
Anorectal Function ◽  
Puborectalis Muscle ◽  
Myoelectric Activity ◽  
Sphincter Pressure ◽  
High Resolution Manometry ◽  
Anal Sphincter Pressure

AbstractThere is a need for a lower cost manometry system for assessing anorectal function in primary and secondary care settings. We developed an index finger-based system (termed “digital manometry”) and tested it in healthy volunteers, patients with chronic constipation, and fecal incontinence. Anorectal pressures were measured in 16 participants with the digital manometry system and a 23-channel high-resolution anorectal manometry system. The results were compared using a Bland-Altman analysis at rest as well as during maximum squeeze and simulated defecation maneuvers. Myoelectric activity of the puborectalis muscle was also quantified simultaneously using the digital manometry system. The limits of agreement between the two methods were −7.1 ± 25.7 mmHg for anal sphincter resting pressure, 0.4 ± 23.0 mmHg for the anal sphincter pressure change during simulated defecation, −37.6 ± 50.9 mmHg for rectal pressure changes during simulated defecation, and −20.6 ± 172.6 mmHg for anal sphincter pressure during the maximum squeeze maneuver. The change in the puborectalis myoelectric activity was proportional to the anal sphincter pressure increment during a maximum squeeze maneuver (slope = 0.6, R2 = 0.4). Digital manometry provided a similar evaluation of anorectal pressures and puborectalis myoelectric activity at an order of magnitude less cost than high-resolution manometry, and with a similar level of patient comfort. Digital Manometry provides a simple, inexpensive, point of service means of assessing anorectal function in patients with chronic constipation and fecal incontinence.

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