Related Experiment Video
Updated: May 27, 2025
06:46
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
2.7K
High-Resolution Manometry With Solid Provocative Test in Patients With Mid-Thoracic and Epiphrenic Esophageal
Loris Baravian1, Chloé Melchior2, Sofia Hambli1
1Department of Gastroenterology, Claude Huriez Hospital, University of Lille 2, Lille, France.
Neurogastroenterology and Motility
|February 18, 2025
Summary
High-resolution manometry (HRM) reveals esophageal motility disorders in half of patients with esophageal diverticula (ED). Provocative testing with solid food swallows enhances diagnosis, suggesting abnormal distensibility in ED patients.
Area of Science:
- Gastroenterology
- Esophageal Physiology
- Diagnostic Imaging
Background:
- Esophageal diverticula (ED) studies using high-resolution manometry (HRM) are limited.
- Understanding motility disorders in ED patients is crucial for diagnosis and management.
Purpose of the Study:
- To characterize esophageal motility disorders in ED patients using HRM.
- To evaluate the diagnostic utility of provocative testing in this population.
Main Methods:
- Retrospective analysis of 39 ED patients undergoing HRM (2010-2022).
- Comparison of HRM findings using single water swallows (SWS) and provocative solid food swallows.
- Calculation of median pressure slopes during the compartmentalization phase.
Main Results:
- 51.3% of patients exhibited motility disorders on SWS, including achalasia and esophagogastric junction obstruction.
- Provocative solid food swallows altered HRM diagnosis in 24.1% of cases, primarily due to elevated integrated relaxation pressure (IRP).
- Elevated median pressure slopes were observed irrespective of diagnosed motility disorders.
Conclusions:
- Approximately half of patients with mid- or lower ED present with HRM-detectable motility disorders.
- Incorporating solid food swallows improves the diagnostic accuracy of HRM in ED patients.
- Elevated pressure slopes suggest abnormal esophageal distensibility in ED patients, even without overt motility disorders.
Related Concept Videos
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
46
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
46
01:26Esophageal Strictures-II: Clinical Features and Management
32
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
32
01:21Barrett Esophagus-II: Clinical Manifestations and Management
99
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
99
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
54
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
54
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
79
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
79
01:26Endoscopic Procedures V: ERCP
58
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
58