Article
Otorhinolaryngology
Fritz Ruprecht Murray, Lara Maria Fischbach, Valeria Schindler, Larissa Schnurre, Juliane Marie Hente, Aurora Tatu, Daniel Pohl
Summary: STM and FLIP have been shown to effectively diagnose esophagogastric junction outflow obstruction (EGJOO) in patients with non-obstructive dysphagia (NOD). Additionally, STM is identified as a cost-effective and clinically meaningful option for diagnosing motility disorders and guiding patients towards interventional treatment.
Review
Surgery
Dolores T. T. Mueller, Brett Parker, Reid Fletcher, Ahmed Sharata, Daniel Davila Bradley, Steven R. R. DeMeester, Kevin M. M. Reavis, Lee L. L. Swanstrom, Christy M. M. Dunst
Summary: The aim of this study was to provide a complete set of HRM data for patients with a normally functioning fundoplication. The results showed that the addition of a fundoplication significantly increased the values of the lower esophageal sphincter. The previously accepted upper limit defining esophageal outflow obstruction may not be clinically applicable after fundoplication.
Article
Medicine, General & Internal
Amir Mari, Rami Sweis
Summary: Dysphagia can range from benign inconvenience to serious morbidity, requiring a detailed clinical assessment to identify underlying diseases. Treatment should be tailored according to the dysmotility phenotype and patient characteristics.
Article
Gastroenterology & Hepatology
Margaret J. Zhou, Afrin Kamal, Daniel E. Freedberg, David Markowitz, John O. Clarke, Daniela Jodorkovsky
Summary: An analysis of patients diagnosed with achalasia revealed a significant increase in the prevalence of type II achalasia and a decrease in type I cases. However, there were no apparent correlations between age or gender and these differences. The findings suggest that advancements in diagnostic techniques and increased awareness of the disease may be contributing factors to the changing epidemiology.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Medicine, General & Internal
Ryusei Nishi, Haruka Amitani, Kazumasa Hamada, Takamasa Fukumoto, Ryuichi Kato, Takako Yamamoto, Yuuki Fuku, Kenichiro Sagiyama, Akihiro Asakawa
Summary: Idiopathic achalasia is a rare esophageal disorder characterized by progressive dysphagia and high lower esophageal sphincter pressure. This case report highlights the importance of considering achalasia when patients present with persistent symptoms, even if initially excluded. Medication is not a definitive treatment, and surgical intervention may be necessary for recovery. The psychosomatic approach can also be beneficial in managing symptoms.
Article
Gastroenterology & Hepatology
Roberto Penagini, Nicola de Bortoli, Edoardo Savarino, Elena Arsie, Salvatore Tolone, Garrett Greenan, Pierfrancesco Visaggi, Daria Maniero, Aurelio Mauro, Dario Consonni, C. Prakash Gyawali
Summary: RDC during high-resolution manometry is an effective surrogate for TBE in assessing esophageal emptying in treated patients with achalasia.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Medicine, Research & Experimental
Daniela Pop, Radu Samuel Pop, Teodora Surdea Blaga, Liliana David, Carmen Asavoaie, Marcel Tantau, Dan Lucian Dumitrascu, Dorin Farcau
Summary: The aim of this study was to explore the diagnosis and treatment of achalasia in children using esophageal HRM. Clinical data and investigation results of seven children with achalasia at a pediatric tertiary center were analyzed. All patients underwent evaluation with conventional esophageal manometry and/or esophageal HRM, and a multidisciplinary team provided diagnosis and treatment. Four children with type II achalasia were treated with POEM and three patients received pneumatic dilations. Overall, achalasia is a rare but challenging condition in children, and diagnosis is based on clinical suspicion, upper digestive endoscopy, and confirmation with esophageal HRM. Treatment should be individualized based on the type of achalasia, age of children, and severity.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Pierfrancesco Visaggi, Matteo Ghisa, Giulio Del Corso, Federica Baiano Svizzero, Lucia Mariani, Salvatore Tolone, Marzio Frazzoni, Andrea Buda, Massimo Bellini, Vincenzo Savarino, Roberto Penagini, C. Prakash Gyawali, Edoardo V. Savarino, Nicola de Bortoli
Summary: The CCv4.0 criteria significantly decreased the prevalence of EGJOO by 80%, refining the diagnosis and identifying clinically relevant outflow obstruction. Elevated RDC-IRP can predict conclusive EGJOO diagnosis per CCv4.0.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Gastroenterology & Hepatology
Dustin A. Carlson, Wenjun Kou, Katharine P. Rooney, Alexandra J. Baumann, Erica Donnan, Joseph R. Triggs, Ezra N. Teitelbaum, Amy Holmstrom, Eric Hungness, Sajiv Sethi, Peter J. Kahrilas, John E. Pandolfino
Summary: Using FLIP panometry and machine learning, a model was developed to predict and classify achalasia subtypes on HRM. The model can differentiate type III achalasia from non-spastic achalasia, with potential for clinical application.
NEUROGASTROENTEROLOGY AND MOTILITY
(2021)
Review
Medicine, General & Internal
Amir Mari, Fadi Abu Baker, Rinaldo Pellicano, Tawfik Khoury
Summary: Achalasia, a rare neurodegenerative disorder causing dysphagia, has seen significant advancements in assessment and management in recent years. Current treatment options include endoscopic and surgical procedures, with POEM emerging as a promising alternative with comparable effectiveness and complication rates to traditional surgeries.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Gastroenterology & Hepatology
Dariush Shahsavari, Zubair Malik, Henry P. Parkman
Summary: EGJOO, defined as elevated integrated residual pressure with preservation of esophageal peristalsis, is proposed to have stricter diagnostic criteria in the recent Chicago classification version 4.0. Treatment options include expectant management for mild or atypical symptoms, while the role of medical treatment seems limited. Additional tests and interventions, such as botox injection, pneumatic dilation, peroral endoscopic myotomy, or Heller myotomy, may be considered for definitive treatment.
CURRENT OPINION IN GASTROENTEROLOGY
(2021)
Article
Pediatrics
Anna Maria Caruso, Denisia Bommarito, Vincenza Girgenti, Glenda Amato, Adele Figuccia, Alessandra Casuccio, Annalisa Ferlisi, Rosaria Genuardi, Sabrina La Fata, Rosalia Mattei, Mario Pietro Marcello Milazzo, Maria Rita Di Pace
Summary: This study analyzed swallowing functions in neurologically impaired (NI) children using esophageal high-resolution manometry (HRM) and established swallow parameters identifying inhalation risk. The results showed alterations in swallowing functions in NI children, which could predispose them to increased inhalation risk.
Article
Otorhinolaryngology
Shumon Dhar, Nogah Nativ-Zeltzer, Omid B. Mehdizadeh, Apoorva T. Ramaswamy, Yuval Nachalon, Peter C. Belafsky
Summary: The results of this pilot study demonstrate that pyridostigmine acutely improves esophageal contractile vigor in patients suffering from dysphagia with esophageal dysmotility. Further investigation with larger sample size, longer follow-up, side effect profile, and patient-reported outcome measures is still needed to determine the clinical usefulness of pyridostigmine in specific disorders of esophageal motility.
Review
Pharmacology & Pharmacy
Marcella Pesce, Rami Sweis
Summary: Achalasia is a rare esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and impaired peristaltic activity. Recent advancements in HRM technology and therapeutic endoscopy have revolutionized the approach to diagnosis and treatment. Comparisons among different treatment options such as POEM, pneumatic dilatation, and surgical Heller myotomy show similar short- and long-term efficacy and complication rates. However, measuring treatment outcomes and the risk of post-treatment reflux remain areas of debate.
THERAPEUTIC ADVANCES IN CHRONIC DISEASE
(2021)
Review
Gastroenterology & Hepatology
Mentore Ribolsi, Gianluca Andrisani, Francesco Maria Di Matteo, Michele Cicala
Summary: Achalasia is an uncommon esophageal motility disorder characterized by altered esophageal body motility and lower esophageal sphincter relaxation. Dysphagia is the most frequent symptom. The diagnosis and management of achalasia have significantly improved with the availability of high-resolution manometry and new therapeutic endoscopic procedures.
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
(2023)
Editorial Material
Gastroenterology & Hepatology
Albert J. Bredenoord
Article
Medicine, Research & Experimental
Jui-Sheng Hung, Shu-Wei Liang, Taher Omari, Ming-Wun Wong, Wei-Yi Lei, Chih-Hsun Yi, Tso-Tsai Liu, Lin Lin, Chien-Lin Chen
Summary: The effects of baclofen on volitional swallowing measures are limited, but it reduces the likelihood of initiation of piecemeal deglutition to large volume challenges.
KAOHSIUNG JOURNAL OF MEDICAL SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Taher Omari, Charles Cock, Peter Wu, Michal Marcin Szczesniak, Mistyka Schar, Jan Tack, Nathalie Rommel
Summary: This study aimed to establish a methodology for diagnosing oropharyngeal disorders using P-HRM-I. The results showed that UES relaxation pressure was the best indicator for differentiating patients from controls and diagnosing UES disorders. A diagnostic scheme was also devised to identify patients with UES disorder or propulsive disorder. Additionally, the study found that patients with pharyngeal pressurizations and evidence of reduced UES relaxation and/or distensibility had higher aspiration scores.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Per Cajander, Taher Omari, Anders Magnuson, Harry Scheinin, Mika Scheinin, Johanna Savilampi
Summary: Dexmedetomidine affects pharyngeal swallowing and esophageal motility, which should be considered in clinical patient management and when choosing sedative agents for procedural sedation or manometric examination.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Sherif Saleh, Benjamin D. Liu, Sophie Trujillo, Charles Thomas, Ronnie Fass
Summary: This study demonstrates that hormone replacement therapy and combined oral contraceptives are associated with an increased risk of gastroesophageal reflux disease (GERD), while the commonly used progesterone-based contraceptive Nexplanon has a limited protective effect against GERD.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Rena Yadlapati, C. Prakash Gyawali, Dustin A. A. Carlson, John E. E. Pandolfino, Ronnie Fass, Abraham Khan, Haiying Lin, Joel E. E. Richter, Marcelo F. Vela, Michael F. Vaezi, John O. O. Clarke
Summary: This study assessed the reliability of FLIP measurements and found that normative FLIP parameters can be extracted from FLIP videos using both real-time and post hoc analyses. There is high consistency between novice and experienced users.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Jeroen M. Schuitenmaker, Thijs Kuipers, Marlies P. Schijven, Andre J. P. M. Smout, Paul Fockens, Albert J. Bredenoord
Summary: This study evaluated the effect of an electronic positional therapy wearable device on nocturnal gastroesophageal reflux. The results showed that the device improved reflux symptoms, reduced the number of reflux episodes, and promoted left lateral decubitus sleep position, leading to improvement in reflux parameters.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Daniel Martin Simadibrata, Eko Ngadiono, Fira Alyssa Gabriella Sinuraya, Ivan Damara, Ronnie Fass, Marcellus Simadibrata
Summary: The use of GerdQ questionnaire for diagnosing GERD has shown to be effective and easy to use. However, there are inconsistent recommendations regarding its use as a diagnostic test. This meta-analysis evaluates the diagnostic accuracy of GerdQ for GERD diagnosis.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Letter
Gastroenterology & Hepatology
Per Cajander, Taher Omari, Harry Scheinin, Mika Scheinin, Johanna Savilampi
Summary: It is important to consider the impact of anesthetic agents on esophageal function testing. Dexmedetomidine has been found to affect primary peristalsis in esophageal manometry, and in the case reports by Toaz et al., secondary peristalsis during FLIP panometry was also affected. This may be due to a specific pharmacodynamic effect, with a transient direct alpha 2-mediated effect on esophageal smooth muscle, associated with a high plasma concentration before sympathetic inhibition begins.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Sudharshan Achalu, Rani Berry, Justin Zhuo, Albert J. Bredenoord, John O. Clarke, Ronnie Fass, C. Prakash Gyawali, Peter J. Kahrilas, David A. Katzka, Benson T. Massey, Roberto Penagini, Sabine Roman, Edoardo Savarino, Marcelo F. Vela, Afrin N. Kamal
Summary: This study aimed to develop a dysphagia-specific question prompt list (QPL) to improve patient-physician communication. A two-round Delphi method and survey were used to generate a QPL consisting of 40 questions, incorporating both expert and patient perspectives.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Review
Gastroenterology & Hepatology
Gengqing Song, Sophie Trujillo, Yuhan Fu, Fahmi Shibi, Jiande Chen, Ronnie Fass
Summary: Gastrointestinal dysmotility refers to muscle or nerve dysfunctions in the GI tract, leading to abnormalities in GI motor and sensory function. Current treatment involves diet and lifestyle changes, with limited effectiveness of pharmacotherapy. Transcutaneous electrical stimulation (TES), a noninvasive technique using electrical stimulation via non-needle electrodes, has shown to be beneficial in managing GI motility disorders.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Gastroenterology & Hepatology
Benjamin D. Liu, Sharon C. Udemba, Sherif Saleh, Hannah Hill, Gengqing Song, Ronnie Fass
Summary: The study indicates that raloxifene increases the risk of GERD, esophageal stricture, and Barrett's esophagus in postmenopausal women with osteoporosis. It was also found that raloxifene was identified as a risk factor for these complications in multivariate analysis.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Critical Care Medicine
Sanith S. Cheriyan, Mistyka S. Schar, Charmaine M. Woods, Shailesh Bihari, Charles Cock, Theodore Athanasiadis, Taher I. Omari, Eng H. Ooi
Summary: This study aimed to investigate the mechanistic effects of a tracheostomy on swallowing using pharyngeal high-resolution manometry with impedance (P-HRM-I). The results showed that in tracheostomised patients, there were significant increases in hypopharyngeal intrabolus pressure and upper oesophageal sphincter (UOS) integrated relaxation pressure, as well as reductions in UOS opening extent and relaxation time. Total pharyngeal contractility was also significantly elevated. These findings suggest that tracheostomy may result in UOS dysfunction, but does not contribute to pharyngeal weakness.
CRITICAL CARE AND RESUSCITATION
(2023)
Article
Gastroenterology & Hepatology
Guy Boeckxstaens, Stefanie Elsen, Ann Belmans, Vito Annese, Albert J. Bredenoord, Olivier R. Busch, Mario Costantini, Uberto Fumagalli, Andre J. P. M. Smout, Jan Tack, Tim Vanuytsel, Giovanni Zaninotto, Renato Salvador
Summary: The 10-year follow-up of the European Achalasia Trial comparing endoscopic pneumodilation (PD) with laparoscopic Heller myotomy (LHM) showed that both treatments are equally effective in treating achalasia, with limited risk of developing gastro-oesophageal reflux.