High-Resolution Manometry Reveals Normal Esophageal Motility, Including Lower Esophageal Sphincter Function, After Vagus Nerve-Preserving Gastrectomy

ABSTRACT Introduction: High resolution manometry is the current technology used to the study of esophageal motility and is replacing conventional manometry in important centers for esophageal motility with parameters used on esophageal motility, following the Chicago Classification. This classification unifies high resolution manometry interpretation and classifies esophageal disorders. Objective: This review shows, in a pictorial presentation, the new parameters established by the Chicago Classification, version 3.0, aimed to allow an easy comprehension and interpretation of high resolution manometry. Methods: Esophageal manometries performed by the authors were reviewed to select illustrative tracings representing Chicago Classification parameters. Results: The parameters are: Esophagogastric Morphology, that classifies this junction according to its physiology and anatomy; Integrated Relaxation Pressure, that measures the lower esophageal sphincter relaxation; Distal Contractile Integral, that evaluates the contraction vigor of each wave; and, Distal Latency, that measures the peristalsis velocity from the beginning of the swallow to the epiphrenic ampulla. Conclusion: Clinical applications of these new concepts is still under evaluation.

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

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.264.haa ◽

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

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

Scientific Reports ◽

10.1038/s41598-021-87052-x ◽

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.

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