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PubMed1990

[The value of pharyngo-esophageal manometry in the study of deglutition disorders].

Pharyngoesophageal manometry is an excellent tool for the study of pharyngeal swallowing disorders, and allows quantifying the various anomalies. The comparison of pre- and postoperative results allows better differentiation of the indications for myotomy or myectomy of the cricopharyngeal muscle. On the basis of a series of 10 cases with sufficient distance in time, the operation can be regarded as even more beneficial as the manometric anomalies are confined to the sole upper esophageal sphincter.

Adult↗
PubMed1990

[Rectoanal perfusion manometry--methods and results in healthy persons].

The authors elaborated a method of rectoanal perfusion manometry as part of the objective examination of the functional state of continence structures. They describe in detail the examination method and manometric equipment. In a group of 10 volunteers, 8 incontinent patients and 23 subjects after operations causing improved continence they draw attention to the great sensitivity and specificity of the examination as well as to the correlation of manometric results with results of Holschneider's evaluation by a point system. This method should be used in departments concerned with rectoanal surgery.

Adult↗
PubMed1990

[Constipation symptoms studied by a standard questionnaire and anorectal manometry before and after promontory rectopexy (Orr-Loygue technic) in 25 female patients].

Intractable constipation is frequently observed after rectopexy. The aim of our study was to look for clinical and manometric data, which could help to predict postoperative constipation. Twenty-five consecutive female patients treated by Orr-Loygue rectopexy were asked to answer a standard questionnaire and underwent anorectal manometry pre- and postoperatively. Nineteen patients complained of constipation after surgery. Preoperative constipation was significantly more frequent in patients who complained of postoperative constipation, than in patients who did not. Preoperative colonic transit time study in 8 patients was not useful in predicting postoperative constipation. Moreover, symptoms of constipation were quite similar pre- and postoperatively in the 19 patients complaining of postoperative constipation. Anorectal manometric data were not different between patients who complained of postoperative constipation and patients who did not. Therefore preoperative complaints of constipation are most important to consider before rectopexy.

Adult↗
PubMed1990

Antroduodenal manometry in the evaluation of chronic functional gastrointestinal symptoms.

Intraluminal pressure in the gastric antrum and duodenum was studied in 44 children and adolescents referred for evaluation because of functional symptoms, including vomiting, abdominal distension, and abdominal pain. Manometric abnormalities were found in 39 patients (89%). Abnormalities during fasting included absence of the migrating motor complex; retrograde, phase 3-like episodes; increased frequency, decreased duration, and decreased amplitude of phase 3 episodes; tonic duodenal contractions; nonpropagated bursts of duodenal contractions; and consistently low-amplitude or absent contractions. Postprandial abnormalities included a phase 1-like pattern (postprandial hypomotility) and phase 3-like episodes (failure to induce a fed pattern). The presence or absence of the migrating motor complex was a predictor of disability. Parenteral alimentation was needed by only 4 of 28 patients with the migrating motor complex, but by 13 of 16 patients without the migrating motor complex (P less than .001). In 15 of 18 patients studied on consecutive days, oral cisapride was associated with increases in the number and amplitude of duodenal contractions after a complex-liquid meal (P less than .02). It is concluded that antroduodenal manometry is a useful technique that elucidates the underlying gastrointestinal motility disorder present in the majority of children and adolescents with severe functional symptoms.

Adolescent↗
PubMed1989

[The importance of manometry in the evaluation of long-term results after surgical therapy of functional disorders of the esophagus].

In the years 1979-1986, 73 patients with oesophageal achalasia, 110 patients with the reflux disease of oesophagus and paraoesophageal herniae, 17 patients with oesophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. There were 446 examinations performed on the whole. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in oesophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of oesophagus it can contribute to the decision between a conservative and surgical therapy. The postoperation control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

Adolescent↗
PubMed1989

[Tubal manometry: the question of normal values, values in chronic mesotympanic purulent middle ear infections].

We investigated tubal function by equalization manometry in 68 patients with unilateral traumatic perforation of the tympanic membrane, and in 116 patients with chronic mesotympanic suppuration (85 dry and 31 discharging ears). Our criterion of normal tubal function is the ability to equalize a difference in pressure of +/- 30 hPa by means of at most 7 swallowings. This result was achieved in only 25% of the dry perforations and in none of the patients with discharging ears. Normal tubal function may only be expected in 25% of patients with chronic otitis media.

Adolescent↗
PubMed1989

[Perfusion pyeloureterography with manometry].

The degree of obstruction of the upper urinary pathways is assessed from the relative pressure value which is calculated by subtracting the intravesical pressure from the intrapelvic one. The intrapelvic pressure is measured after puncture of the renal pelvis by perfusion manometry. By using a contrast substance it is possible to perform at the same time antegrade pyeloureterography. The author presents experience assembled with 20 patients.

Adolescent↗
PubMed1986

[Systemic scleroderma. Contribution of esophageal manometry].

Oesophageal motor function was studied by oesophageal manometry in 48 patients with progressive systemic sclerosis: 25 with proximal scleroderma and 23 with diffuse scleroderma. Oesophageal lesions were noted in 70% (74% in diffuse scleroderma; 64% in proximal scleroderma). Classical manometric signs of scleroderma were found in only 31% of patients. Peristaltic modifications might begin at the junction of the two muscular coats, since a four centimeter long aperistaltic suspended area was noted in that region in 20% of patients, especially in the proximal scleroderma group. Oesophageal motility and low lower oesophageal sphincter pressure account for the gastro-oesophageal reflux and may compromise respiratory function, as suggested by the high frequency of concurrent oesophageal and respiratory dysfunction in diffuse scleroderma. Systematic prevention of gastro-oesophageal reflux should perhaps be advocated as soon as abnormalities in oesophageal motility are diagnosed.

Adolescent↗
PubMed1977

Improved infusion system for intraluminal esophageal manometry.

An improved catheter infusion system is needed for esophageal intraluminal manometry. Using conventional syringe-pump infusion systems undesirably rapid infusion rates of 6 ml per min or more are often needed to achieve accurate recording of esophageal peristaltic pressure. These rapid base line infusion rates are necessitated by the high compliance of syringe-pump systems which causes substantial reduction in the infusion rate during dynamic pressure transients. In this study we tested a hydraulic-capillary infusion system designed to have low compliance. This minimally compliant system yields accurate recording of esophageal peristaltic pressure at infusion rates of 0.6 ml per min or less. We believe that the hydraulic-capillary infusion system is a useful tool for performing both clinical and investigative studies of esophageal motor function.

Adolescent↗
PubMed1987

Achalasia or malignancy? Confirmation of the diagnosis by oesophageal manometry.

Malignancy involving the gastro-oesophageal junction can present with features very similar to those of idiopathic achalasia. Failure to identify such cases may delay effective treatment of a curable tumour. We report four patients with malignant dysphagia who were initially referred for treatment of achalasia--the diagnosis based on clinical, radiographic and endoscopic findings in each case. In all four, oesophageal manometry suggested, correctly, that the diagnosis of achalasia was incorrect, allowing early surgical exploration. We suggest that the diagnosis of achalasia should be confirmed by manometric studies--particularly in elderly patients with a short history and weight loss as these features are frequently associated with malignancy.

Aged↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in irritable colon. II. Repeated oral administration].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive 3 daily doses of 100 mg tiropramide, 150 mg trimebutine maleate or 20 mg octilonium bromide, orally during 5 consecutive days. Before and after treatment, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Before treatment and after 2 and 5 days, the specific symptoms were also monitored, scored and recorded. Significant variations in tonus were not observed with any drug, but while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and, mainly, with octilonium. The overall power of spontaneous colonic contractions did not vary significantly with any drug. However, while with tiropramide a significant redistribution of muscular power was observed so as to increase propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium and trimebutine no clinically relevant redistribution of the power wasted in transient spasms was observed. Based on these observations, tiropramide was considered to be at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, but was different from both reference drugs because it was the only one to act simultanously as both an antispasmodic and a synchronizer. The three drugs produced an improvement in each and all monitored symptoms as well as in the overall symptom intensity. Tiropramide, however, produced an improvement significantly faster, more progressively and to a greater extent than either reference drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

[Comparative value of anorectal manometry and electrocardiography in the diagnosis of diabetic autonomic neuropathy].

Searching for silent anorectal autonomic neuropathy, we investigated the anorectal sensorimotor function in 79 continent diabetics. Thirty four per cent of the patients had a basal anal sphincter pressure lower than 40 mm Hg N = 54.5 +/- 15.5 mm Hg and 11 p. 100 had a threshold of conscious rectal sensation higher than 20 ml (N less than or equal to 20 ml). An electrocardiogram was performed and the change in heart rate resulting from successive deep breaths was recorded for each patient. Cardiac autonomic neuropathy was diagnosed when cardiac frequency did not change with ventilation. This was reflected by a ratio E/I (largest RR space during expiration on the electrocardiogram to the shortest during inspiration) close to one. Compared to cardiac criteria for autonomic neuropathy, the sensitivity of anorectal manometry in the detection of diabetic autonomic neuropathy was 77.2 p. 100 and specificity was 82 p. 100. Low basal anal sphincter pressure in asymptomatic diabetics seems to be a sensitive and specific criteria for the assessment of diabetic autonomic neuropathy and correlates closely with cardiac criteria.

Adult↗
PubMed1985

Measurement and comparison of gastric emptying and esophageal manometry in patients with reflux esophagitis.

Forty-two patients with reflux esophagitis were referred for gastric emptying evaluations. Esophageal manometry was performed on them. Gastric emptying was significantly delayed in patients with reflux esophagitis compared to normal subjects. Lower esophageal sphincter pressure (LESP) showed no significant difference between patients and controls. Acid clearing test was prolonged in patients with reflux esophagitis more than in normal subjects. The subjects were divided into two groups for gastric emptying evaluations; a group with delayed gastric emptying and one with rapid gastric emptying as compared with normal criteria. LESP in 7 cases of rapid gastric emptying among 42 patients (16.6%) was only significantly lower than in normal subjects. The pathogenesis of reflux esophagitis had been previously thought to be a low LESP and/or a prolonged acid clearing. However, we think that a delayed gastric emptying may be one of the pathogenetic characteristics.

Esophagitis, Peptic↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in the irritable colon: I. Administration by single i.v].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive a single intravenous dose of 50 mg tiropramide, 50 mg trimebutine maleate or 10 mg octilonium bromide. Before and after injection, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Significant variations in tonus were not observed with any drug, but, while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and octilonium. The overall power of spontaneous colonic contractions did not vary significantly with tiropramide, whereas some decrease was observed with trimebutine, and a substantial one with octilonium. Moreover, while with tiropramide and, to a lesser extent, with trimebutine there was a significant redistribution of muscular power so as to increase phasic propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium only a decreased wave amplitude was recorded without alteration of the frequency of transient spasms. Based on these observations, tiropramide was evaluated as being at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, while setting itself aside from both reference drugs as it was the only one to act contemporarily as both an antispasmodic and a synchronizer.

Adult↗
PubMed1985

[Diagnosis of isolated tracheo-esophageal fistula by manometry of the esophagus].

A method for diagnosis of isolated tracheo-oesophageal fistula by oesophageal manometry is described. It consists of pull-through registration of intraluminal pressures. An abrupt pressure rise in the area of the fistula during inspiration is pathological. In principle, this method consists of the graphical tracing of the original Koops test which we have slightly modified. The investigation is non-invasive and accurate in comparison with roentgenological and/or endoscopical methods.

Esophagus↗
PubMed1985

[Methodologic studies of manometry of the rectum].

For the purpose of an experimental study in which the three different types of pressure catheters most commonly used in anorectal manometry were compared, a Starling-resistance could be established. Under equal conditions the pressures could be changed in this resistance and the data obtained by using a membrane-catheter, an open-tip and an open-side-catheter were compared among one another and to the known ideal straight line. The open tip catheter measures the opening pressure and the recorded pressure does not necessarily reflect the pressure at the site of the tip hole. Because of its elastic and plastic characteristics, the membrane-catheter yielded the best results with prestretch of the membrane and with calibration before and after each study.

Anal Canal↗
PubMed1985

[Cystometry: comparative values of water manometry and the "Mikro-Tip" method in the assessment of urinary stress incontinence].

Urethro-cystometry carried out on 20 patients with urinary stress incontinence which was clinically apparent gives quite different results if it is carried out using the water manometry technique of Bech-Heidenreich or using a Mikro-Tip technique without perfusion. Comparing the two techniques shows: --little or no difference in the measurement of the functional length of the urethra and the maximum pressure of closure of the urethra. --no difference between the form of the urethral surface at rest and the bladder surface on effort. --on the other hand it shows a very definite difference in the urethral surfaces on effort which depends on the large differences occasioned by the transmission factor. The latter is weak with the Heidenreich method and corresponds to the clinical state; it is raised with the micro-tip method, which contradicts the clinical evidence.

Adolescent↗
PubMed1985

[Manometry studies in the evaluation of anal continence].

In a complex measuring program performing anorectal perfusion manometry a great number of parameters were determined in incontinent patients, patients after continence improving operations and in healthy persons. In this way, we were able to select 20 parameters in which healthy persons differ from incontinent patients, the difference occurring with a security of 99.0 to 99.9%. Our investigations were carried out with test persons at rest, after distension of the rectal ampulla, during abdominal straining and coughing. Rectoanal resting profiles and stress profiles were recorded and the measuring values obtained compared with an anamnestic score.

Adolescent↗