Esophageal motor disorders: How to bridge the gap between advanced diagnostic tools and paucity of therapeutic modalities?

John O. Clarke, John E. Pandolfino*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

High-resolution manometry has added significantly to our current understanding of esophageal motor function by providing improved detail and a data analysis paradigm that is more akin to an imaging format. Esophageal pressure topography provides a seamless dynamic representation of the pressure profile through the entire esophagus and thus, is able to eliminate movement artifact and also assess intrabolus pressure patterns as a surrogate for bolus transit mechanics. This has led to improved identification of anatomic landmarks and measurement of important physiological parameters (esophagogastric junction relaxation, distal latency, and contractile integrity). This research has bridged the gap into clinical practice by defining physiologically relevant phenotypes that may have prognostic significance and improve treatment decisions in achalasia, spasm, and hypercontractile disorders. However, more work is needed in determining the etiology of symptom generation in the context of normal or trivial motor dysfunction. This research will require new techniques to assess visceral hypersensitivity and alterations in central modulation of pain and discomfort.

Original languageEnglish (US)
Pages (from-to)442-448
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume46
Issue number6
DOIs
StatePublished - Jul 2012

Keywords

  • achalasia
  • esophageal pressure topography
  • high-resolution manometry
  • impedance planimetry

ASJC Scopus subject areas

  • Gastroenterology

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