Impact of the COVID‐19 pandemic on high‐resolution manometry and peroral endoscopic myotomy for esophageal motility disorder in Japan

ABSTRACT Aims and Objective: High‑resolution esophageal manometry is the most important investigation for the evaluation of patients with dysphagia and noncardiac chest pain (NCCP). Chicago Classification (CC) utilizing an algorithmic approach in analyzing high‑resolution manometry has been accepted worldwide, and an updated version, CC v3.0, of this classification has been developed by the International high‑resolution manometry working Group in 2014. Data on the spectrum of esophageal motility disorders in Indian population are scarce as well as a newer version of CC has not been used to classify. The aim of our study is to evaluate clinical presentation and manometric profile of patients with suspected esophageal motility disorders using CC v3.0. Methodology: In this retrospective study, consecutive patients referred for esophageal manometry at our center from 2010 to 2015 were included in the study. High‑resolution esophageal manometry was performed with 22‑channel water‑perfusion system (MMS, The Netherlands). Newer version of CC (CC v3.0) was used to classify motility disorders. Results: A total of 400 patients were included, with a mean age of 44 years and 67.5% were males. Out of these, 60% (n = 240) patients presented with motor dysphagia while 40% (n = 160) had NCCP. Motility disorder was present in 50.5% (n = 202) of the patients while 49.5% (n = 198) patients had normal manometry. Disorders of esophagogastric junction outflow were the predominant type of disorder, found in 33.75% (n = 135). About 14.25% (n = 57) of the patients had minor disorders of peristalsis while 5% (n = 20) of the patients had other major disorders of peristalsis. Achalasia was the most common motility disorder present in 30% (n = 120) patients. Conclusion: Dysphagia was the most common esophageal symptom followed by NCCP in our series. Achalasia was the most common esophageal motility disorder followed by fragmented peristalsis.

Download Full-text

Normal Functional Luminal Imaging Probe Panometry Findings Associate With Lack of Major Esophageal Motility Disorder on High-Resolution Manometry

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2020.03.040 ◽

2020 ◽

Cited By ~ 4

Author(s):

Alexandra J. Baumann ◽

Erica N. Donnan ◽

Joseph R. Triggs ◽

Wenjun Kou ◽

Jacqueline Prescott ◽

...

Keyword(s):

High Resolution ◽

Esophageal Motility ◽

Motility Disorder ◽

Esophageal Motility Disorder ◽

Imaging Probe ◽

High Resolution Manometry ◽

Normal Functional ◽

Functional Luminal Imaging Probe

Download Full-text

Tu1127 PERORAL ENDOSCOPIC MYOTOMY FOR PATIENTS WITH ESOPHAGEAL EPIPHRENIC DIVERTICULUM AND ESOPHAGEAL MOTILITY DISORDER

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.975 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB570

Author(s):

Shinwa Tanaka ◽

Masato Kinoshita ◽

Hiroya Sakaguchi ◽

Hirofumi Abe ◽

Ryusuke Ariyoshi ◽

...

Keyword(s):

Esophageal Motility ◽

Motility Disorder ◽

Peroral Endoscopic Myotomy ◽

Epiphrenic Diverticulum ◽

Esophageal Motility Disorder ◽

Endoscopic Myotomy

Download Full-text

High Resolution Impedance Manometry: A Necessity or Luxury in Esophageal Motility Disorder?

American Journal of Case Reports ◽

10.12659/ajcr.909717 ◽

2018 ◽

Vol 19 ◽

pp. 998-1003

Author(s):

Han Sin Boo ◽

Ian Chik ◽

Chai Soon Ngiu ◽

Shyang Yee Lim ◽

Razman Jarmin

Keyword(s):

High Resolution ◽

Esophageal Motility ◽

Motility Disorder ◽

Esophageal Motility Disorder

Download Full-text

Sex differences in symptoms, high‐resolution manometry values and efficacy of peroral endoscopic myotomy in Chinese patients with achalasia

Journal of Digestive Diseases ◽

10.1111/1751-2980.12922 ◽

2020 ◽

Vol 21 (9) ◽

pp. 490-497

Author(s):

Ying Xu ◽

Bi Xing Ye ◽

Yan Wang ◽

Yun Bao ◽

Xiao Su Chen ◽

...

Keyword(s):

Sex Differences ◽

High Resolution ◽

Peroral Endoscopic Myotomy ◽

Chinese Patients ◽

High Resolution Manometry ◽

Endoscopic Myotomy

Download Full-text

Role of Rapid Drink Challenge During Esophageal High-resolution Manometry in Predicting Outcome of Peroral Endoscopic Myotomy in Patients With Achalasia

Journal of Neurogastroenterology and Motility ◽

10.5056/jnm19135 ◽

2020 ◽

Vol 26 (2) ◽

pp. 204-214 ◽

Cited By ~ 3

Author(s):

Hélène Foisy ◽

Mathieu Pioche ◽

Edouard Chabrun ◽

Thierry Ponchon ◽

Frank Zerbib ◽

...

Keyword(s):

High Resolution ◽

Peroral Endoscopic Myotomy ◽

High Resolution Manometry ◽

Predicting Outcome ◽

Endoscopic Myotomy

Download Full-text

Achalasia: current therapeutic options

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622317710010 ◽

2017 ◽

Vol 8 (6-7) ◽

pp. 101-108 ◽

Cited By ~ 6

Author(s):

Zubin Arora ◽

Prashanthi N. Thota ◽

Madhusudhan R. Sanaka

Keyword(s):

Esophageal Motility ◽

Heller Myotomy ◽

Symptomatic Relief ◽

Treatment Options ◽

Motility Disorder ◽

Pneumatic Dilation ◽

Esophageal Peristalsis ◽

Esophageal Motility Disorder ◽

Endoscopic Myotomy ◽

Esophageal Sphincter

Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia. Management of achalasia mainly involves improving the esophageal outflow in order to provide symptomatic relief to patients. The most effective treatment options for achalasia include pneumatic dilation, Heller myotomy and peroral endoscopic myotomy (POEM), with the latter increasingly emerging as the treatment of choice for many patients. This review focusses on evidence for current and emerging treatment options for achalasia with a particular emphasis on POEM.

Download Full-text

Manometrically jackhammer esophagus with fluoroscopically/endoscopically distal esophageal spasm: a case report

BMC Gastroenterology ◽

10.1186/s12876-021-01808-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Apichet Sirinawasatien ◽

Pallop Sakulthongthawin

Keyword(s):

Chest Pain ◽

High Resolution ◽

Gastrointestinal Endoscopy ◽

Motility Disorder ◽

Upper Gastrointestinal Endoscopy ◽

Channel Blockers ◽

Esophageal Motility Disorder ◽

High Resolution Manometry ◽

Esophageal Spasm ◽

Upper Gastrointestinal

Abstract Background Jackhammer esophagus is a rare esophageal motility disorder that can result in dysphagia, chest pain, and gastro-esophageal reflux symptoms. High-resolution manometry is the gold standard for diagnosis, while corkscrew esophagus on upper gastrointestinal endoscopy is an uncommon manifestation. Case presentation 72-year-old man who presented with progressive dysphagia for three months without symptoms of chest pain or heartburn. Initial workup showed a corkscrew esophagus on upper gastrointestinal endoscopy; subsequently, high-resolution manometry revealed an esophago-gastric junction outflow obstruction with hypercontractile (jackhammer) esophagus. Treatment with calcium channel blockers and proton pump inhibitors was successful and relieved his symptoms near completion. Conclusions Even though the corkscrew esophagus is typically for distal esophageal spasm, the hypercontractile (jackhammer) esophagus can appear. The high-resolution manometry can help to distinguish each specific motility disorder.

Download Full-text