Novel Pressure-Impedance Parameters for Evaluating Esophageal Function in Pediatric Achalasia.
J Pediatr Gastroenterol Nutr
; 66(1): 37-42, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-28604515
OBJECTIVE: In achalasia, absent peristalsis and reduced esophagogastric junction (EGJ) relaxation and compliance underlie dysphagia symptoms. Novel high-resolution impedance manometry variables, that is, bolus presence time (BPT) and trans-EGJ-bolus flow time (BFT) have been developed to estimate the duration of EGJ opening and trans-EGJ bolus flow. The aim of this study was to evaluate esophageal motor function and bolus flow in children diagnosed with achalasia using these variables. METHODS: High-resolution impedance manometry recordings from 20 children who fulfilled the Chicago Classification (V3) criteria for achalasia were compared with recordings of 15 children with normal esophageal high-resolution manometry findings and no other evidence suggestive of achalasia. Matlab-based analysis software was used to calculate BPT and BFT. RESULTS: Both BPT and BFT were significantly reduced in achalasia patients compared with children with normal esophageal motility (BPT 3.3âs vs 5.1âs Pâ<â0.01; BFT 1.4âs vs 4.3âs Pâ<â0.001). BFT was significantly lower than BPT (achalasia difference 1.9âsâ±â1.3âs, Pâ=â0.001 and normal difference 0.9â±â0.3âs, Pâ=â0.001). Overall, there was a significant correlation between BPT and BFT (râ=â0.825, Pâ<â0.001). We observed a 2-way differentiation of achalasia patients; those in whom the BPT and BFT were proportional, but significantly lower than in patients with normal peristalsis, and those in whom BFT was disproportionately lower than BPT. CONCLUSIONS: Calculation of BPT and BFT may help determine whether esophageal bolus transport to the EGJ and/or esophageal emptying through the EGJ are aberrant. For achalasia, this may detect flow resistance at the EGJ, potentially improving both diagnosis and objective assessment of therapeutic effects.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pressão
/
Acalasia Esofágica
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Impedância Elétrica
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Motilidade Gastrointestinal
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Manometria
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article