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At least 379 records · Page 21Linked to original sources
PubMed1999

Standard oesophageal manometry in healthy adults in Singapore.

Data on oesophageal manometry in normal subjects in the East are limited. The aim of this study was to define standard oesophageal pressure values in a group of healthy adults in Singapore. Standard oesophageal manometry was performed on 26 asymptomatic volunteers (12 males and 14 females, aged 19 to 34 years) using the water-perfused capillary system and stationary pull-through technique. Median (range) lower oesophageal sphincter pressure, distal oesophageal contractile amplitude, distal oesophageal contractile duration and distal oesophageal contractile velocity were 13.6 (8.0 to 32.0) mmHg, 93.0 (41.0 to 143.0) mmHg, 3.8 (3.2 to 5.3) s and 3.6 (2.2 to 4.6) cm/s respectively. They were similar in males and females except for distal oesophageal contractile velocity which was higher in males than females [4.0 (3.1 to 4.6) cm/s versus 3.2 (2.2 to 4.4) cm/s, P < 0.01]. They were also generally in line with published normal values from Western countries. The present study helps to establish standards for normal manometric findings, at least among the young adults, in this part of the world.

Adult↗
PubMedDate not supplied

Esophageal manometry and 24-hour pH monitoring to evaluate laparoscopic Lind fundoplication in gastroesophageal reflux disease.

Laparoscopic and thoracoscopic techniques have provided a new dimension in the correction of functional disorders of the esophagus. Therapeutic success, however, depends on the confirmation of esophageal disease as a cause of the symptoms, on understanding the basic cause of dysfunction and on identifying the surgical patient. This study is a retrospective study of patients submitted to surgery using the Lind procedure for gastroesophageal reflux disease (GERD). The purpose of this study is to establish the value of the routine use of esophageal manometry and 24-hour pH monitoring in order to select patients and perform pre and postoperative functional evaluation. Forty-one patients (68.3%) had a hypotonic lower esophageal sphincter. The average pressure was 9.2 mm Hg preoperatively and 15.2 mm Hg postoperatively, with an increase of 6.0 mm Hg. This increase was 8.8 mm Hg in hypotonics and 4.3 mm Hg in the normotonics. There was a certain degree of hypomotility of the esophageal body in 14 patients (23.3%) and, of this group, 4 (28.5%) improved postoperatively. Pathological acid reflux was found in 51 cases (85.0%) by pH monitoring. The mean of the preoperative DeMeester score was 31.4, later dropping to 3.2. Esophageal manometry and 24-hour pH monitoring are effective methods for revealing the level of functional modification established by anti-reflux surgery and for helping to objectively perform the selection.

Adolescent↗
PubMed1999

[Intraoperative manometry in laparoscopic antireflux procedures --indications, methods and clinical results].

UNLABELLED: The aim of the study is evaluating the efficiency of intraoperative manometry during laparoscopic Nissen fundoplication and its ability to prevent postoperative complications. METHOD: Sixteen patients with Gastroesophageal Reflux Disease were included in the study. Clinical examinations, x-ray, endoscopy, pH-metry, and manometric studies were performed before, and 3-6 m.o. after surgery. Fourteen patients were undergoing Nissen fundoplication, and two "floppy Nissen" fundoplications due to the specific preoperative manometric indications. RESULTS: Postoperatively the mean proportion of time at pH < 4.0 on pH-metry decreased from 188 min. (range 96-263) to 8.5 min. (range 2-25). Mean number of reflux episodes significantly lowered after fundoplication from 18.9 (range 2-36) to 0.5 (range 0-3). Gastroesophageal junction mean pressure measured postoperatively reached 24.7 mmHg, and was significantly higher than preoperatively (8.9 mmHg). Mean length of LES increased from 1.2 cm (range 0.8-2.5) to 3.6 cm (range 2.4-4.6) postoperatively. CONCLUSIONS: Laparoscopic Nissen fundoplication assisted by the simultaneous continuous intraoperative manometry is feasible and effective procedure. Continuous LES pressure monitoring during laparoscopic fundoplication with simultaneous computer-video assisted display can be advised as an objective method of intraoperative evaluation of antireflux mechanism.

Adult↗
PubMed2001

Importance of the anorectal manometry in chronic anal fissure.

This publication presents the results of postoperative manometric investigations of 77 patients with anal fissure treated within the time span 1985-1997 by lateral sphincterotomy (LS). Results of manometric investigations are compared with digital anal examinations and subjective complaints of patients. Digital anal examination correlated with manometry results in 52 cases (68%). The correspondence between these two results was proved in 48 cases when normal finding was present. An increased sphincter tonus was found in 3 patients, all of them having the anal fissure recurrences. A marked sphincters insufficiency, which had been manifested by stool and gas incontinence was found in one case. When searching for the reason of this complication we found out that this operation procedure had been performed by an unexperienced team of surgeons. In 25 cases (32%) the digital anal assessment and manometric measurement were different. Nevertheless, the clinical symptoms in this group of patients were rather poor. To conclude we may state that manometry provides important data for preoperative evaluation of anal sphincter function and should be performed prior to lateral sphincterotomy operation at least in women.

Adolescent↗
PubMed2003

Effect of morphine and M-cholinoceptor blocking drugs on human sphincter of Oddi during choledochofiberscopy manometry.

OBJECTIVE: To evaluate the effects of morphine on the human sphincter of Oddi pressure and the antagonism of anticholinergic agents against morphine. METHODS: The action of these drugs on the sphincter of Oddi (SO) was evaluated by means of choledochofiberscopy manometry in 40 operated patients with T-tube. The patients were divided randomly into 4 groups: anisodamine, atropine, buscopan, and control. The following data were recorded: duodenal pressure (DP), basal pressure of the sphincter of Oddi (BPSO), contractive amplitude of the sphincter of Oddi (CASO), contractive frequency of the sphincter of Oddi (CFSO), contractive duration of the sphincter of Oddi (CDSO), and pressure of the common bile duct (PCBD). Both morphine and anticholinergic agents were given intramuscularly. RESULTS: After injection of 10 mg morphine, BPSO, CASO, CFSO, and PCBD increased significantly. After injection of 15 mg anisodamine or 0.75 mg atropine, CASO, BPSO declined obviously, and after injection of 20 mg buscopan, CASO, BPSO, CFSO declined obviously, but in anisodamine, atropine and buscopan groups, they differed insignificantly. CONCLUSIONS: The results illustrate that SO manometry via choledochofiberscopy is a new method for SO dynamic study. Morphine can increase DP, BPSO, CASO, PCBD, but anisodamine atropine and buscopan can antagonize the effect of morphine.

Adult↗
PubMed2003

[Dynamic biliary manometry: display modelling and graphic interpretation].

Tendencies of development of biliary manometry have been analyzed. Key advantages and problems of manometric investigation of biliary tracts have been summarized. New method of graphic registration and pressure monitoring in biliary tracts called biliary manometry has been suggested. Characteristic types of manometric curves were determined using stand modelling, their physical and mathematical analysis was conducted, clinical analogues have been suggested. The emphasis has been made on expediency of its further elaboration and clinical application.

Bile Duct Diseases↗
PubMedDate not supplied

Status evaluation: sphincter of Oddi manometry. American Society for Gastrointestinal Endoscopy. Technology Assessment Committee.

SO manometry appears to be helpful in defining a group of patients with biliary pain or idiopathic recurrent pancreatitis who may benefit from endoscopic or surgical treatment. It is a procedure that requires considerable time and endoscopic expertise along with knowledge of the manometric interpretation of sphincter of Oddi dysfunction. The diagnostic accuracy of SO manometry and criteria for basing therapeutic decisions on manometric findings need further study and verification.

Biliary Tract Diseases↗
PubMed2004

[Evaluation of endoscopic sphincter of Oddi manometry in patients with biliopancreatic diseases].

Diagnostic ability of endoscopic sphincter of oddi manometry for 112 patients with biliopancreatic diseases (including 12 patients of normal) was evaluated. The presence of abnormal high pressure was recognized in 50% of suspected sphincter of oddi dysfunction (SOD). 56% of cholecystolithiasis, 67% of cholecystocholedocholithiasis and 50% of pancreatic stones. Many patients with abdominal pain of suspected SOD or stones of biliopancreatic ducts were considered to have possibility of the complication of papillary stenosis. It was thought that endoscopic sphincter of oddi manometry was a useful method of confirming the presence of SOD.

Calculi↗
PubMed2004

Post PSRRP anorectol manometry--experience of 115 cases of imperforate anus.

The conventional treatment of high and intemiediate anomalies of anorectal malformations is proximal pelvic colostomy in neonate (day 1) followed by PSARP (postsagittal anorectoplasty) by the age of 4-6 months and closure of colostomy when adequate dilatation of neo-anus has been performed using Nol 2 or 13 Hegar's dilator or No4 St Mark's anal dilator, It is usually done 3 months after the PSARP operation (anorectal pull through), ie, around 9 months. So the child born without anus in the perineum should be able to pass stool via his or her neo-anus by the age of 9 months and they should ideally be penneally continent. The present study, between August 1993 and December 1999, on the anorectal continence evaluation by doing anorectal manometry was carried out in 115 babies who underwent PSARP operation and subsequent closure of the colostomy. The study showed intermediate anomalies dominated the picture in both males and females (103 babies belonging to intermediate anomalies and 12 babies having high anomalies). In all these children the results of continence have been studied both clinically (Kiesewetter criteria) and by anorectal manometry.

Anus, Imperforate↗
PubMed2005

[Could the peroperative manometry of the oesophagus be used for prediction of dysphagia following antireflux procedures?].

A possible development of the postoperative persisting dysphagia, which decreases the quality of life of the operated, remains the main drawback of the laparoscopic antireflux surgery. Among several variations of the antireflux surgical procedures, there is none known to completely eliminate this risk. In this study, supported by the IGA MZ CR ND 7142-3 grant, peroperative measurements of the lower oesophageal sphincter (LES) tone with a concurrent mechanical callibration of the cuff using an oesophageal tube were taken. A complete Nissen-Rossetti cuff was applied in 39 patients. Peroperative increases in the LES tone following the completion of the antireflux cuffs were monitored. The patients continued to be monitored with the aim to detect the onset of dysphagia. In the patient group with the peroperative LES tone increase exceeding 15 mmHg, significantly higher rates of prolonged dysphagia were recorded. In cases of lower LES increases, the rates of dysphagia were low and good functioning to prevent any pathological gastrooesophageal reflux was maintained. No complication with respect to the peroperative oesophageal manometry was recorded. Duration of the antireflux operation conducted with the peroperative manometry was prolonged by 4 minutes, on average. Based on the assessment of the data, the authors demonstrate that the LES tone increase on its own, does not provide for the antireflux efect of the fundoplication procedures and that the patients cannot benefit from its extremely high values. On the contrary, its high values may indicate possible risks of dysphagia in the postoperative period.

Deglutition Disorders↗
PubMed1992

Manometry during food ingestion aids in the diagnosis of diffuse esophageal spasm.

It has been shown that food ingestion can provoke esophageal motor abnormalities in patients with otherwise normal manometry. Such motor abnormalities are usually nonspecific in character. We now report water swallow and food ingestion data on 12 patients with a history of dysphagia and/or chest pain who satisfied strict manometric diagnostic requirements for diffuse esophageal spasm. Three of these patients had normal water swallow manometry, yet, during food ingestion, showed manometric evidence of diffuse esophageal spasm. In the other nine patients, the occurrence of nonperistaltic contractions was greater, and there was a greater incidence of nonperistaltic contractions of 100 mm Hg or more after ingestion of food. We conclude that food ingestion increases the diagnostic yield of manometric testing for diffuse esophageal spasm and, not infrequently, magnifies an abnormality seen during standard water-swallow testing.

Adult↗
PubMed1992

Intraindividual variability of anorectal manometry parameters.

The present study investigates the intraindividual day-to-day variability of anorectal manometry parameters. Manometric studies were performed in twelve healthy volunteers on three different days. A low compliance capillary perfusion system was used. The values measured on day 1 and day 2, as well as those on day 2 and day 3, showed no significant (p greater than 0.05) differences for any parameter in Wilcoxon's test. Mean percentage of differences as a measure for intraindividual day-to-day variation was relatively low for anal resting (mean: 13.5%) and maximal squeeze (17.5%) pressure. However, it was high for the threshold volumes for minimal perception (71.8%) and urgency to defecate (38.5%) during rectal balloon distention as well as for the minimal volume required to abolish recovery of the rectoanal inhibitory reflex (41.2%). We conclude that anal resting pressure and maximal squeeze pressure both are the most stable anorectal manometry parameters in man, at least over a period of a few days.

Adult↗
PubMed2005

[Effects of different drugs on the sphincter of Oddi motility: study with choledochoscope manometry].

OBJECTIVE: This study assessed the effects of narcotic analgesics, nitrates drugs, somatostatin analogues on human sphincter of Oddi motility and the antagonistic effects of nitrates drugs and anticholinergic agents against morphine measured by choledochoscope manometry. METHODS: 157 patients who had a T tube after cholecystectomy and choledochotomy were assessed by choledochoscope manometry. They were randomly divided into 5 groups. Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duration of contractions (SOD), duodenal pressure (DP), common bile duct pressure (CBDP) were scored and analyzed. RESULTS: SOBP, SOCA and SOF increased after injection of morphine and Ap-237, CBDP increased after intramuscular administered morphine. No apparent change occurred after intramuscularly administered pethidine. SOBP and SOCA decreased after tramadol. After intravenous administration of stilamin in a dose of 250 microg/h, SOCA increased. After administration stilamin of 500 microg/h dose, SOCA and SOBP declined. After intravenous administration of sandostatin, CBDP increased obviously. BPOS and SOCA decreased significantly after administration of isosorbide dinitrate (ISDN) and glyceryl trinitrate (GTN), SOBP reduced evidently after application of pentaerythritol tetranitrate (PTN). SOBP, SOCA, SOF and CBDP increased evidently after injection of morphine. After associated application of ISDN and GTN, the four indications above decreased. As to associated application with PTN, SOCA and SOF decreased. After associated application of anisodamine or atropine, SOCA, SOBP declined, after injected buscopan, SOCA, SOBP, SOF all declined. CONCLUSION: The regular dose of morphine and Ap-237 shows excitatory effect on the sphincter of Oddi motility. Tramadol shows inhibitory effect on the sphincter of Oddi. The regular dose of pethidine and sandostatin shows no apparent effect on the sphincter of Oddi. Stilamin in low dose shows excitated effect on the sphincter of Oddi. Nitrates drugs show inhibited effects on SO motility. Nitrates drugs and anticholinergic agents can antagonize the excitated effect of morphine.

Adult↗
PubMed2006

Ambulatory oesophageal manometry and pH monitoring for investigation of chest pain: a New Zealand experience.

AIMS: Patients with chest pain of uncertain origin are often referred to gastroenterology to assess for possible oesophageal causes. Oesophageal spasm is difficult to ascertain with stationary manometry, as pain seldom occurs during this brief study. Twenty-four-hour ambulatory manometry and oesophageal pH recording (AMP) offers the opportunity to correlate pain symptoms with abnormal motility or acid reflux for more definitive diagnosis. AMP has been available at Christchurch Hospital since 2000 and we describe our experience. METHODS: Thirty-seven patients (23 female, 14 male) underwent AMP between January 2000 and January 2004. Tracings were analysed by automated software and manually by an experienced scientist and gastroenterologist. Case-notes were reviewed for history and drug data. RESULTS: Thirty-three patients (89%) experienced typical pain and/or dysphagia symptoms during AMP. Twenty-one had no correlation between symptoms and pH or manometric abnormalities, excluding reflux disease or an oesophageal hypercontractile disorder as a cause of symptoms. Only one patient had oesophageal spasm proven. One patient's pain correlated strongly with acid reflux. Seven others had reflux episodes during AMP with less consistent pain correlation. At least six patients required treatment for ischaemic heart disease after a negative AMP result. CONCLUSIONS: AMP has been a useful additional investigation for chest pain and was able to exclude oesophageal causes of pain in most patients studied. Oesophageal spasm appears to be a rare cause of chest pain in Christchurch. When a diagnosis was made on AMP, it was most often gastro-oesophageal reflux disease.

Adolescent↗
PubMed1991

[Anorectal manometry and ileo-anal anastomosis].

Seventeen patients (12 ulcerative colitis, 5 familial adenomatous polyposis) underwent proctocolectomy and ileal J pouch anastomosis. Anal manometry with determination of maximum tolerable volume and a liquid continence test were perform before ileo-anal anastomosis, before closure of the loop ileostomy and 12 months after closure of the loop ileostomy. All patients were continent during the daytime less 12 months after proctocolectomy. The mean stool frequency was 5 stools per day in our 17 patients. A significant increase in maximum tolerable volume and in the liquid continence test was observed during the first year after closure of the ileostomy. Anal manometry is unnecessary after ileoanal anastomosis, but preoperatively, this test is able to exclude some patients with low anal pressure.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

[Manometry and defecography in constipated patients with dyschezia].

BACKGROUND: Constipation is one of the most frequent disorders in Gastroenterology. Radiologic and physiologic studies are essential to the diagnosis and treatment of constipated patients. OBJECTIVE: We aimed to assess the usefulness of manometry and defecography in constipated patients with suspect of dyssynergic defecation. METHODS: Dyschesic patients referred for anorectal testing, all patients underwent anorectal manometry and defecography. RESULTS: Fifty eight patients consecutive patients referred from 1998 to 2003. According to manometric findings patients were classified in patients without dyssynergia (group I, n = 16) and patients with dyssynergia (group II, n = 42). Group I patients had intussusception (75%), abnormal rectal emptying (56%), rectocele > 2.5 cm (56%), perineal descending (50%) and inadequate opening of the anal canal (38%). Group II patients had inadequate opening of the anal canal (69%), rectocele < 2.5 cm (55%), perineal descending (17%), intussusception (45%) and abnormal rectal emptying (55%). Group I had a higher frequency of perineal descending (p = 0.01) and intussusception (p = 0.044). Group II had a higher frequency of inadequate opening of the anal canal (p = 0.03), and not for inadequate opening of the anorectal angle. CONCLUSIONS: Defecography showed disorders in group I that may contribute to symptomatology, and in group II the inadequate opening of the anal canal suggests the participation of different parts of the external anal sphincter other than puborectalis in the genesis of dyssynergia.

Adult↗
PubMed1991

[Endoscopic manometry of common bile duct and the sphincter of Oddi in patients with biliary tract stones and in controls].

Endoscopic manometry using microtransducer was applied to evaluate the motor activity of the sphincter of Oddi (SO) and common bile duct (CBD) in patients with biliary tract stones and in controls. CBD pressure, SO pressure and the incidence of irregular phasic wave pattern (IRPWP) were relatively higher in patients with biliary tract stones than those in controls. There was no significant difference in CBD and SO pressure between patients with dilated CBD and patients with non-dilated CBD, however the incidence of IRPWP was significant higher in patients with dilated CBD than that in patients with non-dilated CBD. SO pressure and the incidence of IRPWP were significant higher in patients with papillitis than those in patients without it. Patients with valvular orifice of the papilla of Vater showed high incidence of IRPWP, and in such cases it was suggested that SO had different motor functions for CBD and pancreatic duct because these ducts were seen opening onto the papilla separately according to the findings of pancreatocholangiogram. We concluded that endoscopic manometry of CBD and the SO was useful to evaluate the motor activity of SO and provided a basis for the assessment of the motor function mechanism of SO. Our results indicated the motor activity of SO had close relationship with biliary tract stones, CBD dilatation and endoscopic findings of the papilla of Vater.

Adult↗
PubMed1991

[Practical indications for anorectal manometry].

Anorectal manometry has taken on an important role in the investigation of functional anorectal disorders. This investigation studies the two factors, the resistive system and the capacitive system, involved in anorectal function, continence and defecation. Practical indications can be grouped into three categories concerning different aspects of physiopathological, diagnostic and therapeutic interest. Manometry is essential in the investigation of disorders of pelvic static function, is useful in colorectal surgery and of interest in a wide range of proctological diseases.

Anus Diseases↗