BACKGROUND: Manometry is the gold standard investigation of innate or acquired motility disorders in the oesophagus. New technology in the form of high-resolution manometry (HRM) may supplant traditional water-perfused manometry and enhance standardisation of manometric interpretation and reporting. This study reports on a 10-year experience of 5,184 consecutive patients using the traditional methods, and an early experience with HRM. RESULTS: Of 5,184 patients assessed, 4,509 (87%) had both pH and manometry and 675 (13%) had manometry only. 3,523 (78%) of the pH /manometry group had normal motility, 635 (14%) showed ineffective motility (IM), 213 (5%) a non-specific motility disturbance (NSMD), 42 (0.9%) achalasia, 58 (1.3%) nutcracker oesophagus, 22 (0.5%) hypertensive LOS (HLOS), 8 (0.2%) diffuse oesophageal spasm (DOS) and 8 (0.2 %) had scleroderma. For those referred solely for manometry only, 324 (48%) had normal motility, 72 (11%) IM, 51 (8%) NSMD, 175 (26%) achalasia, 16 (2%) nutcracker oesophagus, 32 (5%) HLOS, 1 (0.1%) DOS and 4 (0.6%) had scleroderma. 92 patients to date have been studied with HRM, with enhanced definition of lower oesophageal sphincter (LOS) function. CONCLUSION: For patients referred for reflux related symptoms, motility disorders are present in 22% of the cases. Conversely, of the patients referred for dysphagia, motility disturbances are detected in 52% of the cases sent for manometry. Our initial experience shows that HRM technology is adding a valuable dimension and clearer understanding of motility patterns in the dysphagic patient.
BACKGROUND: Manometry is the gold standard investigation of innate or acquired motility disorders in the oesophagus. New technology in the form of high-resolution manometry (HRM) may supplant traditional water-perfused manometry and enhance standardisation of manometric interpretation and reporting. This study reports on a 10-year experience of 5,184 consecutive patients using the traditional methods, and an early experience with HRM. RESULTS: Of 5,184 patients assessed, 4,509 (87%) had both pH and manometry and 675 (13%) had manometry only. 3,523 (78%) of the pH /manometry group had normal motility, 635 (14%) showed ineffective motility (IM), 213 (5%) a non-specific motility disturbance (NSMD), 42 (0.9%) achalasia, 58 (1.3%) nutcracker oesophagus, 22 (0.5%) hypertensive LOS (HLOS), 8 (0.2%) diffuse oesophageal spasm (DOS) and 8 (0.2 %) had scleroderma. For those referred solely for manometry only, 324 (48%) had normal motility, 72 (11%) IM, 51 (8%) NSMD, 175 (26%) achalasia, 16 (2%) nutcracker oesophagus, 32 (5%) HLOS, 1 (0.1%) DOS and 4 (0.6%) had scleroderma. 92 patients to date have been studied with HRM, with enhanced definition of lower oesophageal sphincter (LOS) function. CONCLUSION: For patients referred for reflux related symptoms, motility disorders are present in 22% of the cases. Conversely, of the patients referred for dysphagia, motility disturbances are detected in 52% of the cases sent for manometry. Our initial experience shows that HRM technology is adding a valuable dimension and clearer understanding of motility patterns in the dysphagic patient.
Authors: John E Pandolfino; Sudip K Ghosh; Qing Zhang; Andrew Jarosz; Nimeesh Shah; Peter J Kahrilas Journal: Am J Physiol Gastrointest Liver Physiol Date: 2006-02-02 Impact factor: 4.052
Authors: A J Bredenoord; M Fox; P J Kahrilas; J E Pandolfino; W Schwizer; A J P M Smout Journal: Neurogastroenterol Motil Date: 2012-03 Impact factor: 3.598
Authors: John E Pandolfino; Monika A Kwiatek; Thomas Nealis; William Bulsiewicz; Jennifer Post; Peter J Kahrilas Journal: Gastroenterology Date: 2008-07-22 Impact factor: 22.682