Maartje M J Singendonk1, Stamatiki Kritas2, Charles Cock3, Lara F Ferris4, Lisa McCall4, Nathalie Rommel5, Michiel P van Wijk6, Marc A Benninga6, David Moore7, Taher I Omari8. 1. Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands; Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia. Electronic address: m.m.j.singendonk@amc.uva.nl. 2. Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia; Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium. 3. Department of Gastroenterology and Hepatology, Repatriation General Hospital, South Australia, Australia. 4. Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia. 5. Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium; Department of Neurosciences, ExpORL, University of Leuven, Leuven, Belgium. 6. Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands. 7. Women's and Children's Hospital, Adelaide. 8. Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia; Department of Gastroenterology and Hepatology, Repatriation General Hospital, South Australia, Australia; School of Medicine, Flinders University, Bedford Park, South Australia, Australia.
Abstract
OBJECTIVE: To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation. STUDY DESIGN: PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated. RESULTS: Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI ≤142 and impedance ratio ≤0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction. CONCLUSIONS: Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification.
OBJECTIVE: To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation. STUDY DESIGN:PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated. RESULTS: Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI ≤142 and impedance ratio ≤0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction. CONCLUSIONS:Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification.
Authors: D A Carlson; T Omari; Z Lin; N Rommel; K Starkey; P J Kahrilas; J Tack; J E Pandolfino Journal: Neurogastroenterol Motil Date: 2016-09-20 Impact factor: 3.598
Authors: M Singendonk; S Kritas; T Omari; C Feinle-Bisset; A J Page; C L Frisby; S J Kentish; L Ferris; L McCall; L Kow; J Chisholm; S Khurana Journal: Obes Surg Date: 2018-05 Impact factor: 4.129
Authors: Maartje J Singendonk; Zhiyue Lin; Charlotte Scheerens; Jan Tack; Dustin A Carlson; Taher I Omari; John E Pandolfino; Nathalie Rommel Journal: Neurogastroenterol Motil Date: 2018-11-13 Impact factor: 3.960
Authors: Maartje M J Singendonk; Lara F Ferris; Lisa McCall; Grace Seiboth; Katie Lowe; David Moore; Paul Hammond; Richard Couper; Rammy Abu-Assi; Charles Cock; Marc A Benninga; Michiel P van Wijk; Taher I Omari Journal: Neurogastroenterol Motil Date: 2019-09-30 Impact factor: 3.598
Authors: T Omari; F Connor; L McCall; L Ferris; S Ellison; B Hanson; R Abu-Assi; S Khurana; D Moore Journal: United European Gastroenterol J Date: 2018-03-08 Impact factor: 4.623