Non-cardiac Chest Pain: Too Hot to Handle, a Tight Squeeze, Nonsense or Off the Wall.
Korean Journal of Gastrointestinal Motility.2000;6(1):71-73.
Korean Journal of Gastrointestinal Motility
2002 (v1, n1) to Present ISSN: 1671-8925
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A Case of a Diffuse Esophageal Spasm Diagnosis by Ambulatory 24 hour Manometry.
Korean Journal of Gastrointestinal Motility.2000;6(1):63-68.
Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific findings on the laboratory based manometry, but DES was diagnosed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry should always be performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature.
Adult ; Chest Pain ; Deglutition Disorders ; Diagnosis* ; Esophageal Spasm, Diffuse* ; Esophagus ; Humans ; Male ; Manometry* ; Swallows
Adult ; Chest Pain ; Deglutition Disorders ; Diagnosis* ; Esophageal Spasm, Diffuse* ; Esophagus ; Humans ; Male ; Manometry* ; Swallows
Segmental Colon Transit Time with Radiopaque Markers in a Delayed-release Capsule.
Korean Journal of Gastrointestinal Motility.2000;6(1):52-60.
BACKGROUNDS/AIM: Scintigraphic measurement of colon transit has been proven useful clinically and in the research area, however this method requires well equipped laboratories. The aim of this study was to develop a new colon transit test using radiopaque markers instead of radiolabeled pellets in a methacrylate-coated capsule. METHODS: Ten healthy volunteers were studied. After simultaneous administration of two methacrylate-coated gelatin capsules containing activated charcoal mixed with 8 mCi of 99mTc or a commercially used radiopaque marker, scintigraphies and plain abdominal X-rays were performed. We compared colon transit profiles as the geometric center at 4, 8, 24, and 48 hours after ingestion of gelatin capsules. This new radiopaque marker test was validated with a scintigraphic method as the gold standard. RESULTS: Geometric centers (mean+/-SEM) of 99mTc-scintigraphy were 0.50+/-0.18 at 4 hours, 1.16+/-0.05 at 8 hours, 3.31+/-0.36 at 24 hours, and 4.16+/-0.29 at 48 hours. Geometric centers of the radiopaque marker method were 0.40+/-0.16, 1.13+/-0.05, 3.33+/-0.37, and 4.18+/-0.30 respectively. Transit profiles were the same with both methods and highly correlated (r=0.994, p < 0.001). The difference between the two methods against the mean for the geometric center was within 2SD. CONCLUSIONS: A colon transit test using radiopaque markers in a methacrylate-coated, delayed release capsule was inexpensive, simple, and reliable. This new test could be applicable when a gamma camera is not available.
Capsules ; Charcoal ; Colon* ; Eating ; Gamma Cameras ; Gelatin ; Healthy Volunteers ; Radionuclide Imaging
Capsules ; Charcoal ; Colon* ; Eating ; Gamma Cameras ; Gelatin ; Healthy Volunteers ; Radionuclide Imaging
Effects of Electroacupuncture on Sphincter of Oddi Motility in Humans.
Korean Journal of Gastrointestinal Motility.2000;6(1):44-51.
BACKGROUND/AIMS: This study was designed to evaluate the effects of electroacupuncture on the sphincter of Oddi (SO) motility in humans and to correlate the manometric findings with plasma cholecystokinin (CCK) levels. METHODS: Eleven patients (M: F= 5: 6) who had various kinds of biliary disorders were enrolled. SO motility was monitored with a conventional low-compliant continously perfused technique using ERCP (n=9) or percutaneous transhepatic cholangioscope (n=2). After baseline monitoring for phasic wave contractions of SO, electroacupuncture was applied at a specific acupoint, GB 34, in these 11 patients. A nonspecific acupoint 5 cm away from GB 34 was selected as a control. Manometric parameters of SO were also checked in 6 subjects during stimulation of the control acupoint. CCK plasma levels were measured during the time course of electroacupuncture stimulation. RESULTS: All the manometric parameters including the basal pressure of SO, amplitude, frequency and duration of phasic wave contraction of SO were significantly decreased (p < 0.05) during electroacupuncture stimulation. The inhibition of SO contractility was accompanied by increased CCK plasma levels. After removal of electroacupuncture stimulation, restoration of amplitude and duration to basal condition were noted. A tendency towards the return of SO contractility was also observed in basal pressure and frequency. Stimulation of the control acupoint, however, did not affect the SO contractility and plasma CCK levels. CONCLUSIONS: Electroacupuncture stimulation of acupoint GB 34 showed reversible inhibition of SO contraction in humans. We speculate that the response of SO to electroacupuncture stimulation may be mediated by some neurohormonal mechanisms including CCK release.
Acupuncture Points ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystokinin ; Electroacupuncture* ; Humans* ; Plasma ; Sphincter of Oddi*
Acupuncture Points ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystokinin ; Electroacupuncture* ; Humans* ; Plasma ; Sphincter of Oddi*
The Prevalences of Gastrointestinal Symptoms in a Rural Community in Korea.
Korean Journal of Gastrointestinal Motility.2000;6(1):31-43.
BACKGROUND/AIMS: Chronic gastrointestinal (GI) symptoms are believed to be common in the general population, but there is a lack of data from Korea. The aim of this study was to estimate the prevalence of chronic gastrointestinal symptoms in a rural community in Korea by using the Bowel Symptom Questionnaire (BSQ), which was based on the multinational diagnostic Rome criteria for functional bowel disorders, as a measure of GI symptoms. METHODS: A cross-sectional survey, using a reliable and valid questionnaire based on the fulfillment of the Rome criteria, was performed in a densely populated district in a Korean rural community on the residents aged 18-69 yr (mean 48 +/- 14 yr). 95.5% responded (n=420). All respondents were interviewed at their home or offices by a team of interviewers. RESULTS: Two thirds of Korean rural residents experience gastrointestinal symptoms and one fifth of them visit a clinic or hospital at least once a year. Prevalences of weekly heartburn, gastroesophageal reflux disease, dyspepsia, irritable bowel syndrome (IBS), and chronic constipation were 5.2% (95% confidence interval [CI], 3.1-7.4), 2.6% (95% CI, 1.1-4.2), 15.5% (95% CI, 11.9-19.0), 8.6% (95% CI, 5.8-11.3), and 24.3% (95% CI, 20.1-28.5) respectively. The prevalence of dyspepsia was 25%, taking medication usage into consideration. Ulcer-like dyspepsia (11.2%) was the most common subtype and 40% of the subjects with dyspepsia were classified into more than one subtype of dyspesia. There was an overlap between subjects with IBS and dyspepsia with 6.1% of dypeptics having IBS and 11.1% of IBS patients having dypepsia. CONCLUSIONS: The prevalence of GERD was low in Korea compared with that of the Western contries. The prevalences of dyspepsia and IBS were similar to those of the Western countries. The most common gastrointestinal symptom in a rural community in Korea is dyspepsia.
Constipation ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dyspepsia ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Korea* ; Prevalence* ; Rural Population*
Constipation ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dyspepsia ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Korea* ; Prevalence* ; Rural Population*
Postprandial Colonic Motor Activity in Patients with Irritable Bowel Syndrome.
Korean Journal of Gastrointestinal Motility.2000;6(1):20-30.
BACKGROUND/AIMS: The purpose of this study was to discover the physiologic difference of a postprandial motor response in different segments of the colon between patients with irritable bowel syndrome and healthy subjects. METHODS: Irritable bowel syndrome patients are categorized into three groups according to their main symptoms; loose stool-dominant (A, n=5), abdominal pain-dominant (B, n=5), constipation-dominant (C, n=6) and the normal control group (n=5). The intraluminal pressure activity was measured with a colonoscopically positioned multilumen manometric catheter. The change of the colonic motility index (MI) is presented as a percent change (mean+/-SE%) over the basal period in response to a meal. RESULTS: 1) In the transverse, descending and sigmoid colon of healthy subjects, the percentage changes in the basal MI during the first 30 min after the meal are significantly increased (p < 0.05-0.01). 2) In the sigmoid colon, the percentage changes in the basal MI during the first 30 min after the meal were 62+/-18 in A, 29+/-18 in B, 12+/-8 in C and 306+/-102% in heathy subjects respectively, which shows a significant difference between the MI of control and healthy subjects (p < 0.05). 3) In B and C, the percentage changes in the basal MI during the first 30 min after the meal in the descending colon were 105+/-38, 11+/-7, respectively, which shows a significant difference between the two groups (p < 0.05). In A and C, the percentage changes in the basal MI during the first 30 min after the meal in the sigmoid colon was 62+/-18, 12+/-8, respectively, which shows a significant change between the two groups (p < 0.05). CONCLUSION: This study suggests that postprandial intraluminal pressure differences play a role in the pathophysiology of irritable bowel syndrome.
Catheters ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Humans ; Irritable Bowel Syndrome* ; Meals ; Motor Activity*
Catheters ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Humans ; Irritable Bowel Syndrome* ; Meals ; Motor Activity*
Changes of Esophageal Motor Function Depending on the Different Types of the Bolus.
Korean Journal of Gastrointestinal Motility.2000;6(1):11-19.
BACKGROUND/AIMS: It is suggested that diffuse esophageal spasm (DES), nutcracker esophagus (NUT), and hypertensive lower esophageal sphincter (HLES) could be re-classified together as a spastic esophageal motility disorder of similar clinical backgrounds. However, there were no studies to evaluate the pathophysiological characteristics of these motor abnormalities. The aim of the study was to evaluate the changes of esophageal motor function depending on the different types of the bolus (water vs semi-solid bolus). METHODS: Twenty-one healthy subjects and 42 subjects with primary esophageal motility disorders (4 DES, 12 NUT, 5 HLES, 12 nonspecific esophageal motility disorders, 9 normal) underwent a perfusion manometry with a low compliance pneumo-hydraulic capillary infusion system. Consecutively, each patient had 10 swallows of water and 10 swallows of Jello, 5 ml each. RESULTS: In the healthy controls, the Jello swallow showed an increased amplitude and duration of distal esophageal contractions, and the velocity of peristalsis was decreased (p < 0.05). Among all patients diagnosed by manometry with the water swallow, 2 cases diagnosed with HLES (40%) and 4 with NUT (33%) were changed to a diagnoses of DES after the Jello swallow. Moreover, HLES was found in 1 patient with DES (25%) and in 6 patients with NUT (50%). CONCLUSIONS: Semi-solid bolus swallows increase the contractile force of the esophagus more than water swallows. A conventional manometric diagnosis could be changed to a different spastic motility disorder of the esophagus after a semi-solid bolus swallow. It is suggested that DES, NUT, and HLES can be considered as a spectrum of spastic esophageal motility disorders sharing a similar pathophysiology.
Capillaries ; Compliance ; Diagnosis ; Esophageal Motility Disorders ; Esophageal Spasm, Diffuse ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Muscle Spasticity ; Nuts ; Perfusion ; Peristalsis ; Swallows ; Water
Capillaries ; Compliance ; Diagnosis ; Esophageal Motility Disorders ; Esophageal Spasm, Diffuse ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Muscle Spasticity ; Nuts ; Perfusion ; Peristalsis ; Swallows ; Water
The Clinical Spectrum of Gastroesophagel Reflux Disease in Korea.
Korean Journal of Gastrointestinal Motility.2000;6(1):1-10.
BACKGROUND/AIM: Heartburn, which was the most common symptom of reflux disease, was unreliably interpreted by Korean patients. Our aim was to evaluate the clinical spectrum of gastroesophageal reflux disease(GERD) in Korea. METHODS: Patients who were diagnosed by an endoscopy or ambulatory pH monitoring at a tertiary medical facility were given a validated questionnaire and the clinical spectrums were prospectively investigated. RESULTS: Seventy one patients were included. Heartburn was occurring in 39 patients and the frequency of heartburn on two or more days a week were found in only 12 patients. Negative impact of reflux symptoms on health related well being were found in 16 patients. The reflux related atypical symptoms were hoarseness(55%), globus sensation(45%), cough(25%), and chest pain(20%). Twenty two patients complained of epigastric pain or discomfort more than 6 times a year, with 13 patients listing abdominal pain as the most bothersome one. The clinical spectrums were not different between endoscopy negative patients and those with esophagitis. CONCLUSIONS: Typical reflux symptoms are absent in a substantial proportion of Korean patients with GERD. True dyspepsia could result from gastroesophageal reflux. GERD needs to be clarified in patients with chronic laryngeal symptoms, cough or chest pain.
Abdominal Pain ; Chest Pain ; Cough ; Dyspepsia ; Endoscopy ; Esophagitis ; Gastroesophageal Reflux ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Korea* ; Prospective Studies ; Thorax ; Surveys and Questionnaires
Abdominal Pain ; Chest Pain ; Cough ; Dyspepsia ; Endoscopy ; Esophagitis ; Gastroesophageal Reflux ; Heartburn ; Humans ; Hydrogen-Ion Concentration ; Korea* ; Prospective Studies ; Thorax ; Surveys and Questionnaires
Korean Journal of Gastrointestinal Motility.1998;4(2):133-138.
The acute to subacute panautonomic polyneuropathy is an uncommon peripheral nerve disease, including (1) acute to subacute onset, (2) widespread and severe sympathetic and parasympathetic failure, and (3) relative or complete sparing of somatic nerve fibers. Widespread sympathetic failure is manifested as severe orthostatic hypotension, anhidrosis, and parasympathetic failure, as indicated dry eyes, dry mouth, and disturbances of bowel and bladder function. Abdominal pain, often colicky, is very common, and gastrointestinal symptoms, such as early satiety, bloating, nausea, vomiting, pain, diarrhea, or alterating constipation and diarrhea, may persist for years. Patients usually have a fixed heart rate (HR) and pupils. There may be an antecedent viral infection but the frequency of infection is unknown. Little information is available on the course and prognosis of panautonomic neuropathy. The mainstay of treatment is supportive for the management of orthostatic hypotension, and bowel and bladder symptoms. We have examined a 66-year-old woman complaining epigastric pain, orthostatic hypotension and voiding difficulty, and we report a case of acute to subacute panautonomic neuropathy presenting as gastrointestinal symptoms.
Abdominal Pain ; Aged ; Constipation ; Diarrhea ; Female ; Gastrointestinal Motility* ; Heart Rate ; Humans ; Hypohidrosis ; Hypotension, Orthostatic ; Mouth ; Nausea ; Nerve Fibers ; Peripheral Nervous System Diseases ; Polyneuropathies* ; Prognosis ; Pupil ; Syncope ; Urinary Bladder ; Vomiting
Abdominal Pain ; Aged ; Constipation ; Diarrhea ; Female ; Gastrointestinal Motility* ; Heart Rate ; Humans ; Hypohidrosis ; Hypotension, Orthostatic ; Mouth ; Nausea ; Nerve Fibers ; Peripheral Nervous System Diseases ; Polyneuropathies* ; Prognosis ; Pupil ; Syncope ; Urinary Bladder ; Vomiting
Korean Journal of Gastrointestinal Motility.1998;4(2):127-132.
Gastroesophageal reflux disease (GERD) is thought to be caused by an incompetent lower esophageal sphincter, either because of a chronic hypotonia or an increased frequency of transient lower esophageal sphincter relaxation. Thus, it seems paradoxical under nutcracker esophagus to consider gastroesophageal reflux as a possible diagnosis, particularly in the patient presenting with chest pain. Current therapy in nutcracker esophagus is aimed at reducing the high amplitude peristaltic contractions characteristic of this disorder. Treatment directed at reducing contraction can decrease lower esophageal sphincter pressure and may exacerbate gastroesophageal reflux. It is not easy to treat a case of nutcracker esophagus associated with GERD. We report a 38-year-old male with nutcracker esophagus associated with GERD who lost the diagnostic features of nutcracker esophagus after 6 week of antireflux therapy.
Adult ; Chest Pain ; Diagnosis ; Esophageal Motility Disorders* ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux* ; Humans ; Male ; Manometry* ; Muscle Hypotonia ; Omeprazole* ; Relaxation
Adult ; Chest Pain ; Diagnosis ; Esophageal Motility Disorders* ; Esophageal Sphincter, Lower ; Gastroesophageal Reflux* ; Humans ; Male ; Manometry* ; Muscle Hypotonia ; Omeprazole* ; Relaxation
Country
Republic of Korea
Publisher
Korean Society of Neurogastroenterology and Motility
ElectronicLinks
http://www.jnmjournal.org/Editor-in-chief
Abbreviation
Korean J Gastrointest Motil
Vernacular Journal Title
대한소화관운동학회지
ISSN
1226-5608
EISSN
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
Description
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