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Am J Physiol Gastrointest Liver Physiol (April 27, 2006). doi:10.1152/ajpgi.00081.2006
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Submitted on February 20, 2006
Accepted on April 19, 2006

Deglutitive Upper Esophageal Sphincter Relaxation: a study of 75 Volunteer Subjects Using Solid-State High-Resolution Manometry

Sudip Kumar Ghosh1*, John E Pandolfino1, Qing Zhang1, Andrew Jarosz1, and Peter J. Kahrilas1

1 Department of Medicine, Northwestern University, Chicago, Illinois, United States

* To whom correspondence should be addressed. E-mail: s-ghosh{at}northwestern.edu.

Aim: This study aimed to use a novel high-resolution manometry (HRM) system to establish normative values for deglutitive upper esophageal sphincter (UES) relaxation. Methods: 75 asymptomatic controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record from the hypopharynx to the stomach. Subjects performed ten 5 ml water swallows and one each of 1, 10, and 20 ml volume swallows. Pressure profiles across the UES were analyzed using customized computational algorithms that measured: 1) the relaxation interval (RI), 2) the median intrabolus pressure (mIBP) during the RI, and 3) the deglutitive sphincter resistance (DSR) defined as mIBP/RI. Results: The automated analysis succeeded in confirming bolus volume modulation of both the RI and the mIBP with the mean RI ranging from 0.32 to 0.50 s and mIBP ranging from 5.93 to 13.80 mmHg for 1 and 20 ml swallow respectively. DSR was relatively independent of bolus volume. Peak pharyngeal contraction during the return to the resting state post-swallow was almost 300 mmHg, again independent of bolus volume. Conclusion: We performed a detailed analysis of deglutitive UES relaxation with a novel HRM system and customized software. The enhanced spatial resolution of HRM allows for the accurate, automated assessment of UES relaxation and intrabolus pressure characteristics, in both cases confirming the volume-dependent effects and absolute values of these parameters previously demonstrated by detailed analysis of concurrent manometry/fluoroscopy data. Normative values were established to aid in future clinical and investigative studies.




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M R Fox and A J Bredenoord
Oesophageal high-resolution manometry: moving from research into clinical practice
Gut, March 1, 2008; 57(3): 405 - 423.
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