Pneumatic dilation improves esophageal emptying and symptoms in patients with idiopathic esophago‐gastric junction outflow obstruction

2018 ◽  
Vol 31 (3) ◽  
pp. e13522 ◽  
Author(s):  
Steven B. Clayton ◽  
Claire M. Shin ◽  
Alex Ewing ◽  
Wojciech Blonski ◽  
Joel Richter
Keyword(s):  
Pneumatic Dilation ◽  
Outflow Obstruction ◽  
Esophageal Emptying

Mo1508 - Pneumatic Dilation Improves Esophageal Emptying on Timed Barium Esophagram in Patients with Esophago-Gastric Junction Outflow Obstruction

2018 ◽  
Vol 154 (6) ◽  
pp. S-734
Author(s):  
Claire M. Shin ◽  
Wojciech C. Blonski ◽  
Joseph A. Ewing ◽  
Steven Clayton ◽  
Joel E. Richter
Keyword(s):  
Pneumatic Dilation ◽  
Outflow Obstruction ◽  
Barium Esophagram ◽  
Esophageal Emptying

Assessment of esophageal emptying post-pneumatic dilation: use of the timed barium esophagram

1999 ◽  
Vol 94 (7) ◽  
pp. 1802-1807 ◽  
Author(s):  
Michael F. Vaezi ◽  
Mark E. Baker ◽  
Joel E. Richter
Keyword(s):  
Pneumatic Dilation ◽  
Barium Esophagram ◽  
Esophageal Emptying

Good esophageal emptying combined with symptom relief predicts long-term success from pneumatic dilation (PD) in achalasia

2000 ◽  
Vol 118 (4) ◽  
pp. A245 ◽  
Author(s):  
Michael F. Vaezi ◽  
Edgar Achkar ◽  
Joel E. Richter
Keyword(s):  
Symptom Relief ◽  
Pneumatic Dilation ◽  
Esophageal Emptying

scholarly journals Improved esophageal emptying in achalasia after pneumatic dilation assessed by changes in symptoms, les pressure (LESP) and a pH reflux test

1978 ◽  
Vol 74 (5) ◽  
pp. 1042
Author(s):  
R. Gross ◽  
L.F. Johnson ◽  
R.J. Kaminski
Keyword(s):  
Pneumatic Dilation ◽  
Esophageal Emptying

scholarly journals Outcome of pneumatic balloon dilatation of lower oesophageal sphincter of oesophagus of patients suffering from achalasia cardia

2016 ◽  
Vol 44 (2) ◽  
pp. 76-81
Author(s):  
ASM Nazmul Islam ◽  
Md Razibul Alamgir ◽  
Mohammed Atiqur Rahman ◽  
Anwarul Kabir ◽  
Faruque Ahmed ◽  
...  
Keyword(s):  
Balloon Dilatation ◽  
Treatment Options ◽  
Lower Oesophageal Sphincter ◽  
Pneumatic Dilatation ◽  
Barium Swallow ◽  
Pneumatic Dilation ◽  
Achalasia Cardia ◽  
Quasi Experimental ◽  
Esophageal Emptying ◽  
Pneumatic Balloon Dilatation

Achalasia is an oesophageal motility disorder of unknown cause, primarily characterized by absence of peristalsis of the esophageal body and impaired relaxation of lower oesophageal sphincter resulting invariably in dysphagia for solids/liquids or both and regurgitation of undigested foods. The diagnosis is usually made by classical symptoms, barium swallow X-ray of oesophagus or by endoscopy. Goal of treatment is to relieve symptoms, improve esophageal emptying and reduce the risk of associate complications. The two most successful treatment options are pneumatic dilation of lower oesophageal sphincter and surgical myotomy. This quasi-experimental study was carried out from January 2010 to December 2011 involving 31 patients of Achalasia Cardia admitted in the Department of Gastroenterology of BSMMU, Dhaka who underwent pneumatic balloon dilatation. Immediately after pneumatic dilatation all the patients got relief of dysphagia and were discharged from hospital next day. At follow-up 4 weeks after pneumatic dilatation, majority (96.2%) of the patients remained improved symptomatically. Significant weight gain was also found at 4 weeks after pneumatic dilatation. Pneumatic dilatation came out to be a simple, safe and effective method for treating patients with achalasia cardia.Bangladesh Med J. 2015 May; 44 (2): 76-81

Intrabolus Pressure Predicts Delayed Esophageal Emptying in EGJ Outflow Obstruction

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S226-S227
Author(s):  
Matthew Hoscheit ◽  
Scott Gabbard
Keyword(s):  
Outflow Obstruction ◽  
Esophageal Emptying

scholarly journals Response to multiple rapid swallows shows impaired inhibitory pathways in distal esophageal spasm patients with and without concomitant esophagogastric junction outflow obstruction

2020 ◽  
Vol 33 (10) ◽  
Author(s):  
Patricia V Hernandez ◽  
Luis R Valdovinos ◽  
Jennifer L Horsley-Silva ◽  
Miguel A Valdovinos ◽  
Michael D Crowell ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Botulinum Toxin Injection ◽  
Pneumatic Dilation ◽  
Outflow Obstruction ◽  
Esophageal Body ◽  
Esophageal Spasm ◽  
Inhibitory Pathways ◽  
Healthy Control ◽  
Endoscopic Myotomy ◽  
Integrated Relaxation Pressure

Summary Distal esophageal spasm (DES) is a motility disorder characterized by premature contraction of the esophageal body during single swallows. It is thought to be due to impairment of esophageal inhibitory pathways, but studies to support this are limited. The normal response to multiple rapid swallows (MRS) is deglutitive inhibition of the esophageal body during the MRS sequence. Our aim was to compare the response to MRS in DES patients and healthy control subjects. Response to MRS during HRM was evaluated in 19 DES patients (8 with and 11 without concomitant esophagogastric junction outflow obstruction [EGJOO]) and 24 asymptomatic healthy controls. Patients with prior gastroesophageal surgery, peroral endoscopic myotomy, pneumatic dilation, esophageal botulinum toxin injection within 6 months of HRM, opioid medication use, and esophageal stricture were excluded. Response to MRS was evaluated for complete versus impaired inhibition (esophageal body contractility with distal contractile integral [DCI] > 100 mmHg-sec-cm during MRS), presence of post-MRS contraction augmentation (DCI post MRS greater than single swallow mean DCI), and integrated relaxation pressure (IRP). Impaired deglutitive inhibition during MRS was significantly more frequent in DES compared to controls (89% vs. 0%, P < 0.001), and frequency was similar for DES with versus without concomitant EGJOO (100% vs. 82%, P = 0.48). The proportion of subjects with augmentation post MRS was similar for both groups (37% vs. 38%, P = 1.00), but mean DCI post MRS was higher in DES than controls (3360.0 vs. 1238.9, P = 0.009). IRP was lower during MRS compared to single swallows in all patients, and IRP during MRS was normal in 5 of 8 patients with DES and EGJOO. Our study suggests that impaired deglutitive inhibition during MRS is present in the majority of patients with DES regardless of whether they have concomitant EGJOO, and future studies should explore the usefulness of incorporating response to MRS in the diagnosis of DES.

scholarly journals Elevated Average Maximum Intrabolus Pressure on High-Resolution Manometry is Associated with Esophageal Dysmotility and Delayed Esophageal Emptying on Timed Barium Esophagram

2021 ◽  
Author(s):  
Katelyn Madigan ◽  
J. Shawn Smith ◽  
Joni Evans ◽  
Steven Clayton
Keyword(s):  
High Resolution ◽  
Esophagogastric Junction ◽  
Esophageal Dysmotility ◽  
Outflow Obstruction ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Average Maximum ◽  
Barium Esophagram ◽  
Esophageal Emptying ◽  
Liquid Bolus

Abstract Background Intrabolus pressure (IBP) recorded by high-resolution manometry (HRM) portrays the compartmentalized force on a bolus during esophageal peristalsis. HRM may be a reliable screening tool for esophageal dysmotility in patients with elevated average maximum IBP (AM-IBP). Timed barium esophagram (TBE) is a validated measure of esophageal emptying disorders, such as esophagogastric junction outflow obstruction and achalasia. This study aimed to determine if an elevated AM-IBP correlates with esophageal dysmotility on HRM and/or delayed esophageal emptying on TBE. Methods A retrospective analysis of all HRM (unweighted sample n=155) performed at a tertiary referral center from 09/2015-03/2017 yielded a case group (n=114) with abnormal AM-IBP and a control group (n=41) with a normal AM-IBP (pressure<17mmHg) as consistent with Chicago Classification 3. All patients received a standardized TBE, with abnormalities classified as greater than 1 cm of retained residual liquid barium in the esophagus at 1 and 5 minutes or as tablet retention after 5 minutes. Results AM-IBP was significantly related to liquid barium retention (p=0.003) and tablet arrest on timed barium esophagram (p=0.011). A logistic regression model correctly predicted tablet arrest in 63% of cases. Tablet arrest on AM-IBP correlated with an optimal prediction point at 20.1 mmHg on HRM. Patients with elevated AM-IBP were more likely to have underlying esophageal dysmotility (95.6% vs. 70.7% respectively; p<0.001), particularly esophagogastric junction outflow obstruction disorders. Elevated AM-IBP was associated with incomplete liquid bolus transit on impedance analysis (p=0.002). Conclusions Our findings demonstrate that an elevated AM-IBP is associated with abnormal TBE findings of esophageal tablet retention and/or bolus stasis. An abnormal AM-IBP (greater than 20.1 mm Hg) was associated with a higher probability of retaining liquid bolus or barium tablet arrest on TBE and esophageal dysmotility on HRM. This finding supports the recent incorporation of IBP in Chicago Classification v4.0.

PREDICTORS OF FAILURE OF PNEUMATIC DILATION IN ACHALASIA

2019 ◽  
Author(s):  
M Ayari ◽  
S Ayedi ◽  
E Bel Hadj Mabrouk ◽  
Y Zaimi ◽  
L Mouelhi ◽  
...  
Keyword(s):  
Pneumatic Dilation
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