No abstract available.
Esophageal Sphincter, Upper* ; Manometry*

No abstract available.
Esophageal Sphincter, Upper

No abstract available.
Deglutition Disorders* ; Esophageal Sphincter, Upper* ; Foreign Bodies*

No abstract available.
Deglutition Disorders* ; Esophageal Sphincter, Upper* ; Suicide*

BACKGROUND/AIMS: The motility change after peroral endoscopic myotomy (POEM) in achalasia is currently focused on lower esophageal sphincter (LES). This study aims to investigate the correlation of motility response between distal and proximal esophagus after POEM. METHODS: A total of 32 achalasia patients who received POEM and high-resolution manometry (HRM) were included for analysis. Eckardt score was used to assess symptom improvement. HRM was applied for studying motility. Main parameters analyzed were (1) LES: resting pressure (restP), 4-second integrated relaxation pressure; (2) esophageal body (EB): contractile integral of distal segment with myotomy (CI-DM) and proximal segment without myotomy (CI-PNM); and (3) upper esophageal sphincter (UES): relaxation pressure (UES-RP). RESULTS: There were 6 type I, 17 type II, and 9 type III achalasia patients included for analysis. (1) Eckardt score, LES tone, CI-DM, CI-PNM and UES-RP were reduced remarkably after POEM (P < 0.001). (2) no significant correlation was noted between LES tone and contractile intergral of EB. (3) a positive linear correlation of CI-DM and CI-PNM changes was detected (P < 0.001). (4) the change of UES-RP was positively correlated with the change of contractile integral of EB (P < 0.001). CONCLUSIONS: Myotomy of the distal esophagus would attenuate proximal EB contraction and assist UES relaxation in achalasia patients after POEM.
Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper* ; Esophagus* ; Humans ; Manometry ; Relaxation*

BACKGROUND/AIMS: Disturbances of esophageal motility have been reported to be more frequent the aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on esophageal motility using high-resolution esophageal impedance manometry (HRIM). METHODS: Esophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (Group A, n = 32), 40–65 years (Group B, n = 185), and > 65 years (Group C, n = 62). Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures, integrated relaxation pressure, distal contractile integral, contractile front velocity, distal latency, and pressures and duration of contraction on 4 positions along the esophagus, and complete bolus transit were measured. RESULTS: Basal UES pressure was lower in Group C (P < 0.001) but there was no significant difference in the LES pressure among groups. Contractile duration on position 3 (10 cm from proximal LES high pressure zone) was longer in Group C (P = 0.001), and the contractile amplitude on position 4 (5 cm from proximal LES high pressure zone) was lower in Group C (P = 0.005). Distal contractile integral was lower in Group C (P = 0.037). Contractile front velocity (P = 0.015) and the onset velocity (P = 0.040) was lower in Group C. There was no significant difference in impedance values. CONCLUSIONS: The decrease of UES pressure, distal esophageal motility, and peristaltic velocity might be related with esophageal symptoms in the aged population.
Aging ; Electric Impedance* ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper ; Esophagus ; Humans ; Manometry* ; Physiology ; Relaxation

No abstract available.
Deglutition Disorders ; Esophageal Sphincter, Upper ; Esophagogastric Junction ; Humans

OBJECTIVE: To evaluate an effect of balloon catheter dilatation on post-swallow laryngeal elevation, total pharyngeal transit time and pharyngeal remnant in stroke patients with cricopharyngeal dysfunction. METHOD: The 20 stroke patients with cricopharyngeal dysfunction in videofluoroscopic swallow study were recruited for the study. Using 16 Fr foley catheter, balloon was positioned across the upper esophageal sphincter under video-fluoroscopy. Balloon catheter dilatation was done for 3 minutes and each ballooning was repeated 6 times for a minute. We compared pre-balloon dilatation and post-balloon dilatation values. 3 factors were evaluated, which were laryngeal elevation, total pharyngeal transit time, and post-swallow pharyngeal remnant. RESULTS: There was no significant difference in laryngeal elevation after balloon dilatation. However, total pharyngeal transit time (p<0.01) and pharyngeal remnant (p<0.001) were significantly reduced after balloon dilatation. CONCLUSION: There were significant decrements of post-swallow total pharyngeal transit time and pharyngeal remnant after balloon dilation procedure. Balloon dilation of upper esophageal sphincter can produce relief of dysphagia in stroke patients with cricopharyngeal dysfunction.
Catheters ; Deglutition ; Deglutition Disorders ; Dilatation ; Esophageal Sphincter, Upper ; Humans ; Stroke

BACKGROUND: The diagnostic criteria of laryngopharyngeal reflux disease (LPRD) is defined differently according to the location of the proximal pH probe: upper esophagus, upper esophageal sphincter (UES) or hypopharynx. Clinically the location of proximal probe is determined by the location of distal probe, which is usually fixed on 5 cm above the lower esophageal sphincter. This study was performed to evaluate the difference in the diagnosis of LPRD between the results from considering the location of the proximal probe and not considering it. METHODS: This study consisted of 76 patients performed esophageal manometry and 24 hour ambulatory pH monitoring of esophagus using the dual probe. According to location of the proximal probe, the patients were divided into 3 groups : upper esophagus, UES and hypopharynx group. Firstly, we used the diagnostic criteria not considering the location of the probe concordantly in all 76 patients : criteria of the upper esophagus, UES and hypopharynx respectively. And then, we used the diagnostic criteria considering the location of the proximal probe. The results were compared. RESULTS: When the diagnostic criteria of upper esophagus was used, 3.9% (3/76) was diagnosed as LPRD. In the case of UES and hypopharynx, 18.4% (14/76) and 38.2% (29/76) was diagnosed as LPRD. When the diagnostic criteria considering the location of the proximal probe was used, 27.6% (21/76) was diagnosed as LPRD. Significant difference was found between the result considering the location of the probe and 3 results not considering it (p<0.01). CONCLUSION: It is thought to be appropriate to use the diagnostic criteria considering the location of the proximal probe for the more accurate diagnosis of LPRD.
Diagnosis ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper ; Esophagus ; Humans ; Hydrogen-Ion Concentration* ; Hypopharynx ; Laryngopharyngeal Reflux* ; Manometry ; Monitoring, Ambulatory

OBJECTIVETo examine the esophageal function of neonates by high resolution manometry (HRM), and to provide preliminary data for research on the esophageal function of neonates.

METHODSEsophageal HRM was performed on neonates using a solid-state pressure measurement system with 36 circumference sensors arranged at intervals of 0.75 cm, and ManoView software was used to analyze esophageal peristalsis pattern.

RESULTSEsophageal HRM was performed successfully in 11 neonates, and 126 occurrences of complete esophageal peristalsis were recorded. Complete esophageal peristalsis with pressure increase was recorded in some neonates but most neonates showed a different esophageal peristalsis pattern compared with adults. Some neonates had no relaxation of the upper esophageal sphincter (UES) when pharyngeal muscles contracted in swallowing, some neonates had multiple swallowing without esophageal peristalsis and some neonates had relatively low pressure of esophageal peristalsis. Full-term infants could have relatively low UES pressure and esophageal sphincter (LES) pressure but some preterm infants showed relatively high UES pressure and LES pressure. Longitudinal contraction of the whole esophagus and elevation of LES after swallowing were recorded in some neonates.

CONCLUSIONSEsophageal HRM is safe and tolerable for neonates. HRM shows that esophageal peristalsis after swallowing may not occur or may be incomplete in neonates. The esophageal function of neonates has not yet been developed completely, with large individual differences in esophageal peristalsis. Large sample data are needed for further analysis and research on the esophageal function of neonates.

Deglutition ; physiology ; Esophageal Sphincter, Lower ; physiology ; Esophageal Sphincter, Upper ; physiology ; Esophagus ; physiology ; Female ; Humans ; Infant, Newborn ; Male ; Manometry ; methods ; Peristalsis