TY - JOUR
T1 - Esophageal motor disorders
T2 - How to bridge the gap between advanced diagnostic tools and paucity of therapeutic modalities?
AU - Clarke, John O.
AU - Pandolfino, John E.
PY - 2012/7
Y1 - 2012/7
N2 - 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.
AB - 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.
KW - achalasia
KW - esophageal pressure topography
KW - high-resolution manometry
KW - impedance planimetry
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U2 - 10.1097/MCG.0b013e31823d30c1
DO - 10.1097/MCG.0b013e31823d30c1
M3 - Review article
C2 - 22688141
AN - SCOPUS:84862299017
SN - 0192-0790
VL - 46
SP - 442
EP - 448
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
IS - 6
ER -