Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.223
Filtrar
1.
N Z Med J ; 134(1531): 91-100, 2021 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-33767490

RESUMO

AIM: This study aimed to determine whether symptoms can reliably predict a major disorder of oesophageal motility as assessed by conventional water perfusion manometry. METHODS: Data from patients who underwent conventional water perfusion oesophageal manometry and a pre-manometry questionnaire between October 1998 and August 2018 were extracted from a database. Clinical features (dysphagia, chest pain, regurgitation, dysphagia to a bread challenge) and combinations of these clinical features were compared to manometric diagnoses. RESULTS: Data from 546 patients were analysed. Thirty-three (6%) patients had a major disorder of motility, and 513 (94%) had normal manometry or a minor disorder of motility. 'Any dysphagia' (dysphagia as a symptom or dysphagia to a bread challenge) or 'chest pain' was experienced by all patients with a major disorder of motility and 435 of 513 patients with normal manometry or a minor disorder of motility (p=0.009). Sensitivity was 100%, and specificity was 15%, in identifying patients with a major disorder of motility using symptom combinations and a bread challenge. CONCLUSION: Symptoms and provoked dysphagia to bread were able to predict patients with a major disorder of oesophageal motility with a sensitivity of 100%. However, as specificity was 15%, confirmation with manometry is indicated if possible.


Assuntos
Transtornos da Motilidade Esofágica/diagnóstico , Manometria/métodos , Dor no Peito/etiologia , Transtornos de Deglutição/etiologia , Feminino , Humanos , Refluxo Laringofaríngeo/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Água
2.
Dtsch Med Wochenschr ; 146(7): 441-445, 2021 04.
Artigo em Alemão | MEDLINE | ID: mdl-33780988

RESUMO

The functional gastrointestinal disorders (FGIDs) have a high prevalence and are associated with high healthcare costs. The diagnosis of these diseases could be difficult and require func-tional tests such as high-resolution manometry (HRM) of the esophagus, anorectal manometry and H2-Breathtests. Due to the COVID-19 Pandemic and the fear of infections there was a marked reduction in the number of performed exams in the last months - nevertheless some exams are necessary, in order to exclude or to diagnose important and dangerous diseases like Achalasia. Goal of this article is to present some new and relevant developments in the field. The HRM of the esophagus is the diagnostic standard for Achalasia, a rare clinical condi-tion associated to dysphagia - new European guidelines suggests a safe strategy in perform-ing the pneumatic dilatation.The intestinal methanogen overgrowth (IMO) is a clinical condition caused by a high production of methane in the small intestine due to overgrowth of Methanobrevibacter smithii, this condition could be in some patients associated with irritable bowel syndrome.


Assuntos
/complicações , Gastroenteropatias/diagnóstico , Archaea/metabolismo , Testes Respiratórios , Acalasia Esofágica/diagnóstico , Esôfago/fisiopatologia , Gastroenteropatias/economia , Gastroenteropatias/epidemiologia , Humanos , Intestino Delgado/microbiologia , Manometria , Metano/biossíntese , Guias de Prática Clínica como Assunto , Reto/fisiopatologia
3.
Am J Gastroenterol ; 116(3): 517-521, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33657040

RESUMO

INTRODUCTION: Systemic sclerosis or scleroderma (SSc) is a chronic autoimmune disease that renders the esophagus prone to significant gastroesophageal reflux due to impaired esophageal clearance and reduced lower esophageal sphincter pressure. The reported prevalence of Barrett's esophagus (BE) in women with SSc varies from 2% to 37% and is derived from older studies with small sample sizes. We aimed to assess the prevalence of BE in a large cohort of women with SSc. METHODS: Women with SSc referred from the Mayo Clinic Arizona Rheumatology Clinic who completed esophagogastroduodenoscopy between 2002 and 2020 were included. Demographic and high-resolution manometry data were evaluated. The diagnosis of scleroderma was confirmed by an expert rheumatologist. The BE diagnosis was confirmed by an expert gastrointestinal pathologist. RESULTS: There were 235 women with SSc who underwent EGD. High-resolution manometry (HRM) was completed in 172 patients. Women with SSc with BE were significantly more likely to have scleroderma esophagus (absent contractility with hypotensive lower esophageal sphincter) on HRM than women with SSc without BE (P = 0.018). There were 30 patients with SSc (12.8%) with histologically proven BE. Dysplasia was found in 13 (43.3%): 4 with indefinite, 7 with low grade, and 2 with adenocarcinoma. The incidence of any dysplasia was 5.3% per year (0.9% per year for adenocarcinoma). DISCUSSION: This the largest study on prevalence of BE in women with SSc, yielding a prevalence of 12.8%. Women with SSc with BE were significantly more likely to have absent contractility with hypotensive lower esophageal sphincter findings on HRM. The high prevalence and incidence of dysplasia found suggest that women with SSc should be included in the screening recommendations for BE.


Assuntos
Transtornos de Deglutição/epidemiologia , Escleroderma Sistêmico/epidemiologia , Adulto , Idoso , Esôfago de Barrett , Comorbidade , Feminino , Humanos , Incidência , Manometria , Prevalência
5.
Artigo em Chinês | MEDLINE | ID: mdl-33541001

RESUMO

Objective:This study aimed to explore the differences in esophageal pressure at different ages, and to analyze the possible age inflection points of the physiological degeneration of esophageal motility, and to further evaluate whether the degeneration of esophageal kinetics with age is the only risk factor for the occurrence of throat reflux disease (LPRD). Methods:A solid-state high-resolution esophageal pressure measurement was performed on 41 volunteers without throat symptoms. The Chicago classification data were compared with the manometry results of all volunteers. In addition, the esophageal manometry results were compared among groups with pre-set age inflection point. Results:Most of the volunteers' esophageal pressure measurements were in line with Chicago standards. When the inflection point of age was 55 years, no significant difference was found between the two groups. However, when the inflection point of age was 65 years, a significant difference in the length of the upper esophageal sphincter and the contractile front velocity was found between the two groups(P=0.021 and 0.046 respectively). Conclusion:Esophageal dynamics was weakened with increasing age in the volunteers without laryngopharyngeal symptoms, which was more obvious after the age of 65, but still within the normal range. The degeneration of esophageal motility is not the only risk factor for LPRD.


Assuntos
Refluxo Laringofaríngeo , Idoso , Esfíncter Esofágico Superior , Humanos , Hipofaringe , Manometria , Pessoa de Meia-Idade , Voluntários
6.
Internist (Berl) ; 62(3): 277-287, 2021 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-33560449

RESUMO

The prevalence of diverticula varies depending on the location within the gastrointestinal tract. Diverticula of the esophagus, stomach and small intestine are rare, more frequent are peripapillary diverticula and colonic diverticula. Meckel diverticula can also be of relevance in adults. Diverticula have to be differentiated from intramural pseudodiverticulosis of the esophagus and bile duct cysts. An endoscopic and radiological diagnostic work-up is only necessary for symptomatic diverticula or complications. In some cases additional functional diagnostic tests, such as high-resolution esophageal manometry to detect underlying motility disorders (Zenker's diverticulum, epiphrenic diverticulum) or the hydrogen breath test to detect bacterial overgrowth in the small intestine (diverticula of the small intestine) are mandatory. Effective treatment requires the close interdisciplinary cooperation between different specialist disciplines. Therapeutic modalities include pharmacotherapy, endoscopy and surgical methods.


Assuntos
Doenças Diverticulares , Adulto , Doenças Diverticulares/diagnóstico , Doenças Diverticulares/terapia , Divertículo Esofágico , Endoscopia , Esôfago , Humanos , Manometria , Divertículo de Zenker
8.
J Laryngol Otol ; 135(2): 153-158, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33551000

RESUMO

BACKGROUND: Transoral robotic surgery is frequently described, driven by the desire to offer a less morbid alternative to chemoradiation. However, the objective evaluation of post-operative function has rarely been reported. Therefore, high-resolution manometry was used in this study to evaluate the impact of changes in peri-operative swallowing function on pharyngeal pressure events. METHODS: Ten patients with various stages of oropharyngeal cancer underwent transoral surgery. High-resolution manometry and videofluoroscopic swallow studies were performed before surgery and two months afterwards. The following parameters were obtained: velopharyngeal and mesopharyngeal post-deglutitive upper oesophageal sphincter pressures, velo-meso-hypopharyngeal contractile integral, upper oesophageal sphincter relaxation pressure, and pharyngeal velocity. RESULTS: There was no significant difference in pharyngeal pressure or contractile integral pre- versus post-operatively. However, pharyngeal velocity was significantly higher post-operatively than pre-operatively. CONCLUSION: High-resolution manometry showed that transoral surgery in patients without pre-operative dysphagia preserved pharyngeal constriction. However, transoral surgery might produce scar formation in the pharynx, which could lead to narrowing of the pharynx.


Assuntos
Deglutição/fisiologia , Neoplasias Orofaríngeas/cirurgia , Faringe/fisiopatologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Transtornos de Deglutição/fisiopatologia , Esfíncter Esofágico Superior/fisiologia , Feminino , Humanos , Masculino , Manometria/métodos , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Período Pós-Operatório , Pressão , Procedimentos Cirúrgicos Robóticos/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia
9.
Arq Bras Cir Dig ; 33(4): e1557, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33503117

RESUMO

BACKGROUND: Water-perfused high resolution manometry system. High-resolution manometry is more costly but clinically superior to conventional manometry. Water-perfused systems may decrease costs, but it is unclear if they are as reliable as solid-state systems, and reference values are interchangeable. AIM: To validate normal values for a new water-perfusion high-resolution manometry system. METHODS: Normative values for a 24-sensors water perfused high-resolution manometry system were validated by studying 225 individuals who underwent high resolution manometry for clinical complaints. Patients were divided in four groups: group 1 - gastroesophageal reflux disease; group 2 - achalasia; group 3 - systemic diseases with possible esophageal manifestation; and group 4 - dysphagia. RESULTS: In group 1, a hypotonic lower esophageal sphincter was found in 49% of individuals with positive 24 h pH monitoring, and in 28% in pH-negative individuals. In groups 2 and 3, aperistalsis was found in all individuals. In group 4, only one patient (14%) had normal high-resolution manometry. CONCLUSIONS: The normal values determined for this low-cost water-perfused HRM system with unique peristaltic pump and helicoidal sensor distribution are discriminatory of most abnormalities of esophageal motility seen in clinical practice.


Assuntos
Esfíncter Esofágico Inferior , Esôfago/fisiologia , Motilidade Gastrointestinal/fisiologia , Manometria/métodos , Adulto , Acalasia Esofágica , Refluxo Gastroesofágico , Humanos , Manometria/instrumentação , Pessoa de Meia-Idade , Peristaltismo , Valores de Referência , Reprodutibilidade dos Testes , Água
10.
Med Clin North Am ; 105(1): 55-73, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33246523

RESUMO

Primary care physicians frequently evaluate patients with constipation. The history is crucial in uncovering warning symptoms and signs that warrant colonoscopy. Particular elements in the history and rectal examination also can provide clues regarding the underlying etiology. Regardless of etiology, lifestyle modifications, fiber, and laxatives are first-line therapies. Patients who fail first-line therapies can be offered second-line treatments and/or referred for testing of defecatory function. In those with severely refractory symptoms, referrals to a gastroenterologist and a surgeon should be considered.


Assuntos
Constipação Intestinal/diagnóstico , Constipação Intestinal/tratamento farmacológico , Adulto , Colonoscopia , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Efeitos Psicossociais da Doença , Fibras na Dieta/uso terapêutico , Exame Retal Digital , Feminino , Humanos , Laxantes/uso terapêutico , Masculino , Manometria , Pessoa de Meia-Idade , Atenção Primária à Saúde , Qualidade de Vida , Fatores de Risco
11.
Ter Arkh ; 92(8): 66-72, 2020 Sep 03.
Artigo em Russo | MEDLINE | ID: mdl-33346464

RESUMO

AIM: To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD. MATERIALS AND METHODS: The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles. RESULTS: Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001). CONCLUSION: Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.


Assuntos
Refluxo Gastroesofágico , Monitoramento do pH Esofágico , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/etiologia , Azia , Humanos , Manometria , Federação Russa/epidemiologia
12.
Codas ; 32(6): e20190006, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33237186

RESUMO

PURPOSE: This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with different levels of voice production. METHODS: four total laryngectomized individuals participated in the study, All patients underwent High Resolution Manometry (MAR) at rest and during phonation. After this process, a descriptive analysis of the results was performed. RESULTS: we observed that during rest the patients had PES pressure below normal and this data may be related to changes in the muscular connections at the level of the upper esophageal sphincter (UES) especially the interruption of the cricopharyngeal plexus. During phonation, two patients presented higher UES pressure values during phonation, when compared to the values found at rest, suggesting that introduction of air into the esophagus is followed by pharyngoesophageal contraction and that during phonation the patients with good esophageal speech may develop more pressure in this region. CONCLUSION: Studies with a greater number of participants may help define, for example, subjects who may benefit from procedures such as cricopharyngeal myotomy or other medical conduct in order to facilitate the acquisition of esophageal voice in these patients.


Assuntos
Laringectomia , Voz Esofágica , Esôfago/cirurgia , Humanos , Manometria , Faringe , Fonação
13.
Am J Gastroenterol ; 115(11): 1799-1801, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33156098

RESUMO

In their article "Use of the Functional Lumen Imaging Probe in Clinical Esophagology," Savarino et al. report the outcomes of a Grading of Recommendations Assessment, Development, and Evaluation analysis performed by experts in the use of functional lumen imaging probe (FLIP) evaluation of esophageal disorders. For essentially all clinical indications, the recommendation for use was conditional with a very low quality of evidence. FLIP is an expensive, invasive technology examining limited aspects of esophageal function. Its role in complementing or replacing existing technology is uncertain, particularly when compared with manometric testing with additional provocative studies. Performing properly designed studies to demonstrate FLIP's true effectiveness and cost-effectiveness will be costly.


Assuntos
Doenças do Esôfago , Testes Diagnósticos de Rotina , Doenças do Esôfago/diagnóstico por imagem , Humanos , Manometria
14.
Rev. esp. enferm. dig ; 112(11): 850-853, nov. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-198769

RESUMO

BACKGROUND: esophageal manometry is the standard criterion for the evaluation of dysphagia and the diagnosis of a primary motor disorder of the esophagus in adults and children. AIMS: to describe the diagnosis according to the Chicago classification (CC) v3.0 in children with dysphagia, in whom an esophageal motility disorder was documented. The associated comorbidities were also determined. METHODS: an observational retrospective study was performed of 54 patients evaluated for dysphagia, who had undergone a high-resolution manometry (HREM). RESULTS: a normal HREM was found in 52 % (n = 28) of the children, whereas 48 % (n = 26) had some esophageal motility disorder. The most frequent diagnosis was ineffective esophageal motility and achalasia. Excluding previously healthy children, most children had a history of autoimmune disease and intellectual disability. CONCLUSIONS: an esophageal motor disorder can be diagnosed in nearly half of infants and children with dysphagia. In this study, all esophageal diseases could be classified according to the CC v3.0. HREM should be considered for the evaluation of children with dysphagia, in addition to other studies


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Transtornos de Deglutição/fisiopatologia , Transtornos da Motilidade Esofágica/fisiopatologia , Transtornos da Motilidade Esofágica/diagnóstico , Estudos Retrospectivos , Manometria/métodos , Estatísticas não Paramétricas , Comorbidade
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2780-2783, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018583

RESUMO

Sleep apnea has a very high prevalence in the general population. Sleep apnea can be the cause for cardiovascular disorders. An increased risk for suffering from hypertension, stroke, and myocardial infarction had been shown in large studies, like the Sleep Heart Health Study. Sleep related breathing disorders and sleep apnea had been diagnosed in sleep laboratories with polysomnography in the past. Today in view of the high prevalence of sleep disordered breathing, home sleep apnea testing (HSAT) has become the accepted test for the diagnosis of sleep apnea, if there are no other comorbidities, and if a high pretest probability was confirmed by a sleep physician. For home sleep apnea testing, the number of sensors needed should be reduced. Some methods use indirect means to derive features to detect sleep apnea and hypopnea events. A very well developed method is peripheral arterial tonometry (PAT). This method records the pulse wave on a finger and derives sleep and sleep apnea feature. The PAT method has been tested under many conditions. As an indirect method, it was long seen as a limitation that obstructive and central sleep apnea events could not be distinguished. A new multicenter trial was set up to develop algorithms, which could distinguish central and obstructive apnea events with sufficient accuracy.


Assuntos
Síndromes da Apneia do Sono , Apneia do Sono Tipo Central , Apneia Obstrutiva do Sono , Humanos , Manometria , Polissonografia , Síndromes da Apneia do Sono/diagnóstico , Apneia do Sono Tipo Central/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico
16.
Vestn Oftalmol ; 136(6): 100-107, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084286

RESUMO

Currently, the level of intraocular pressure (IOP) can be assessed with a large number of tonometers, which differ in the principle of action, the place of application and the degree of invasiveness. All the methods in use - except for direct manometry - allow only indirect judgement of the level of ophthalmotonus. The quality of tonometric measurement is influenced by many factors, from the choice of tonometer to the analysis of the results obtained by the doctor. The use of complex methods for assessing the level of intraocular pressure provides additional information that increases its diagnostic value. This article summarizes current information about modern methods of tonometry, and describes their features.


Assuntos
Médicos , Tonometria Ocular , Humanos , Pressão Intraocular , Manometria
17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 828-835, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047715

RESUMO

OBJECTIVE: To analyze the causes of the esophagogastric junction outlet obstruction (EGJOO) patients, to discuss the differences of the clinical manifestation and esophageal motility characteristics between the anatomic EGJOO (A-EGJOO) and functional EGJOO (F-EGJOO) subgroups, and to search the diagnostic values of the specific metrics for differentiating the subgroups of EGJOO patients. METHODS: For the current retrospective study, all the patients who underwent the esophageal high resonance manometry test were retrospectively analyzed from Jan 2012 to Oct 2018 in Peking University Third Hospital. The EGJOO patients were enrolled in the following research. The clinical characteristics, such as symptoms and causes of the patients were studied. Then the patients were divided into two subgroups as A-EGJOO subgroup and F-EGJOO subgroup. The clinical symptoms and the main manometry metrics were compared between these two subgroups. The significant different metrics between the two groups were selected to draw receiver operating characteristic (ROC) curves and the diagnostic values were analyzed in differentiating the A-EGJOO and F-EGJOO subgroups. RESULTS: The most common symptom of EGJOO was chest pain or chest discomfort (30.63%), then the dysphagia (29.73%), and acid regurgitation/heartburn (27.03%). Non-erosive reflux disease (36.04%) was the most popular cause for EGJOO, then the reflux esophagitis (17.12%). Besides the intra-EGJOO and extra-EGJOO lesions, the connective tissue disease (6.31%) and central nervous diseases (2.70%) were found to be the etiology of EGJOO. The causes of the rest 19 EGJOO were unknown. A-EGJOO patients presented significantly higher intra bolus pressure (IBP) than that of F-EGJOO [6.80 (5.20, 9.20) mmHg vs. 5.10 (3.10, 7.60) mmHg, P=0.016]. The area under curve of IBP was 0.637. When IBP≥5.15 mmHg, the sensitivity was 78.60% and specificity 50.70% to differentiate A- or F-EGJOO. CONCLUSION: Chest pain or chest discomfort was the most common symptom in EGJOO patients. Besides the intraluminal structural disorders, the extra-luminal causes were found in EGJOO patients. A-EGJOO presented higher IBP than that of F-EGJOO patients. The cutoff value of IBP to differentiate A-EGJOO from EGJOO was 5.15 mmHg with sensitivity 78.06% and specificity 50.70%. However for the low area under curve, the diagnostic value of IBP was limited.


Assuntos
Transtornos de Deglutição , Transtornos da Motilidade Esofágica , Transtornos da Motilidade Esofágica/complicações , Transtornos da Motilidade Esofágica/diagnóstico , Junção Esofagogástrica , Humanos , Manometria , Estudos Retrospectivos
18.
PLoS One ; 15(9): e0228761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32991595

RESUMO

There is a need for a lower cost manometry system for assessing anorectal function in primary and secondary care settings. We developed an index finger-based system (termed "digital manometry") and tested it in healthy volunteers, patients with chronic constipation, and fecal incontinence. Anorectal pressures were measured in 16 participants with the digital manometry system and a 23-channel high-resolution anorectal manometry system. The results were compared using a Bland-Altman analysis at rest as well as during maximum squeeze and simulated defecation maneuvers. Myoelectric activity of the puborectalis muscle was also quantified simultaneously using the digital manometry system. The limits of agreement between the two methods were -7.1 ± 25.7 mmHg for anal sphincter resting pressure, 0.4 ± 23.0 mmHg for the anal sphincter pressure change during simulated defecation, -37.6 ± 50.9 mmHg for rectal pressure changes during simulated defecation, and -20.6 ± 172.6 mmHg for anal sphincter pressure during the maximum squeeze maneuver. The change in the puborectalis myoelectric activity was proportional to the anal sphincter pressure increment during a maximum squeeze maneuver (slope = 0.6, R2 = 0.4). Digital manometry provided a similar evaluation of anorectal pressures and puborectalis myoelectric activity at an order of magnitude less cost than high-resolution manometry, and with a similar level of patient comfort. Digital Manometry provides a simple, inexpensive, point of service means of assessing anorectal function in patients with chronic constipation and fecal incontinence.


Assuntos
Canal Anal/fisiopatologia , Constipação Intestinal/diagnóstico , Incontinência Fecal/diagnóstico , Manometria/instrumentação , Reto/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Constipação Intestinal/fisiopatologia , Estudos Transversais , Eletromiografia , Incontinência Fecal/fisiopatologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Manometria/economia , Manometria/métodos , Pessoa de Meia-Idade , Diafragma da Pelve/fisiopatologia , Pressão , Dispositivos Eletrônicos Vestíveis/economia
19.
Zhonghua Wai Ke Za Zhi ; 58(9): 668-671, 2020 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-32878411

RESUMO

The advent of high-resolution esophageal manometry in this century produced manometric types of esophageal achalasia, which was very important for the selection of treatment methods and the assessment of prognosis. The application of 24-hour esophageal pH monitoring combined with impedance played a decisive role in determination of gastroesophageal reflux and refluxant. Advanced technologies such as laparoscopic Heller myotomy and per-oral endoscopic myotomy were used for surgical treatment of achalasia, laparoscopic anti-reflux procedures and magnetic sphincter augmentation were applied to the treatment of gastroesophageal reflux diseases (GERD). These advanced procedures implied that the treatment of primary esophageal motility disorders (PEMD) and GERD came into the minimally invasive era. However, the diagnosis and treatment of PEMD and GERD are not popular enough in our country, the studies and high-level clinical evidences are insufficient on uncommon PEMD and complex GERD, which are the further directions of efforts.


Assuntos
Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica/cirurgia , Acalasia Esofágica/diagnóstico , Acalasia Esofágica/cirurgia , Monitoramento do pH Esofágico , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/cirurgia , Humanos , Manometria , Resultado do Tratamento
20.
Am. j. gastroenterol ; 115(9): 1393-1411, Sep. 2020.
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1146637

RESUMO

Achalasia is an esophageal motility disorder characterized by aberrant peristalsis and insufficient relaxation of the lower esophageal sphincter. Patients most commonly present with dysphagia to solids and liquids, regurgitation, and occasional chest pain with or without weight loss. High-resolution manometry has identified 3 subtypes of achalasia distinguished by pressurization and contraction patterns. Endoscopic findings of retained saliva with puckering of the gastroesophageal junction or esophagram findings of a dilated esophagus with bird beaking are important diagnostic clues. In this American College of Gastroenterology guideline, we used the Grading of Recommendations Assessment, Development and Evaluation process to provide clinical guidance on how best to diagnose and treat patients with achalasia.


Assuntos
Humanos , Acalasia Esofágica/diagnóstico , Acalasia Esofágica/terapia , Junção Esofagogástrica/patologia , Endoscopia do Sistema Digestório , Gerenciamento Clínico , Manometria
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...