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 19 February 2018

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Alternatives for detecting esophageal sphincter relaxations in GERD

High-resolution manometry is at least as accurate as sleeve sensor manometry for the detection of transient lower esophageal sphincter relaxation in GERD, reports the latest issue of the American Journal of Physiology-Gastrointestinal and Liver Physiology.

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Transient lower esophageal sphincter relaxations are the most important mechanism by which gastroesophageal reflux disease (GERD) occurs.

Sleeve sensor manometry is the gold standard for detection of transient lower esophageal sphincter relaxations.

Dr Bredenoord and colleagues from the Netherlands evaluated manometry with closely spaced sideholes (high-resolution manometry) for the detection of transient lower esophageal sphincter relaxations as an alternative.

62% with high-resolution and 57% with sleeve sensor show manometric signs of reflux during esophageal sphincter relaxations
American Journal of Physiology-Gastrointestinal Liver Physiology

The researchers performed 90-min postprandial manometry by using a catheter incorporating both a sleeve sensor and closely spaced sideholes.

The manometry was performed in the esophagogastric junction in 12 patients with GERD and the recordings of both techniques was scored.

The team detected reflux during transient lower esophageal sphincter relaxations by using manometry (common cavity), intraluminal impedance, and pH monitoring.

The researchers reported a total of 145 transient lower esophageal sphincter relaxations that were detected by using both techniques.

The investigative team were able to detect 117 transient lower esophageal sphincter relaxations with high-resolution manometry and 108 with sleeve sensor manometry.

Manometric signs of reflux during transient lower esophageal sphincter relaxations were found in 62% with high-resolution and 57% with sleeve sensor manometry versus 39% and 35% on pH-metry and 70% and 60% on impedance monitoring, respectively.

The team found that transient lower esophageal sphincter relaxations accompanied by reflux, was detected in 60% with manometry and 68% with impedance monitoring.

Transient lower esophageal sphincter relaxations recognized only with high-resolution manometry were accompanied by reflux in 32% versus transient lower esophageal sphincter relaxations recognized only with sleeve sensor in 29%.

Dr Bredenoord's team concludes, “High-resolution manometry is at least as accurate as sleeve sensor manometry for the detection of transient lower esophageal sphincter relaxations.”

Am J Physiol Gastrointest Liver Physiol 2005: 288(6): G1190-G1194
20 May 2005

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