BOOK
Esophageal Function Testing, An Issue of Gastrointestinal Endoscopy Clinics, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue devoted to Esophageal Function Testing highlights these tests that are complimentary to endoscopy and should be considered after endoscopy is performed. In fact, a prerequisite for performing many of these studies is a negative endoscopy and thus, the endoscopist should be well-informed regarding the indication and utility of these tests. Additionally, some of these newer technologies require endoscopy to be performed during the study as the placement or positioning of the measurement tool will require endoscopic landmarks or direct placement. There have been major advances in most of these older techniques, and new novel measurement paradigms have been created that allow for a more visual and accurate depiction of physiologic and anatomic data. These technologies have evolved to be more akin to an imaging technique and thus, the visual display and data acquisition is much more intuitive and easier to teach to trainees. This review would be of the utmost importance to readers of GI Endoscospy Clinics.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Esophageal FunctionTesting | i | ||
| Copyrights | ii | ||
| Contributors | iii | ||
| Contents | v | ||
| Gastrointestinal Endoscopy Clinics Of North America | ix | ||
| New and Improved Methods for Esophageal Function Testing | xi | ||
| Esophageal Function Testing | xiii | ||
| Esophageal Motor Function | 527 | ||
| Key points | 527 | ||
| Introduction | 527 | ||
| Indications and contraindications | 528 | ||
| The procedure | 530 | ||
| Equipment Preparation | 530 | ||
| Patient Preparation | 530 | ||
| Patient Positioning | 530 | ||
| Catheter Insertion | 531 | ||
| Catheter Positioning | 531 | ||
| Technique | 533 | ||
| Landmark Phase | 533 | ||
| Adequate Swallows | 533 | ||
| Provocative Maneuvers | 535 | ||
| Complications and management | 535 | ||
| Postoperative care | 536 | ||
| Reporting, follow-up, and clinical implications | 536 | ||
| Metrics Used in Clinical HRM Interpretation | 536 | ||
| Reporting Manometry Study Findings | 537 | ||
| Follow-Up | 538 | ||
| Clinical Implications | 538 | ||
| Outcomes | 539 | ||
| Reproducibility | 539 | ||
| Comprehension and Retention | 539 | ||
| Current controversies | 539 | ||
| Artifacts | 539 | ||
| Equipment-related artifacts | 539 | ||
| Vascular and respiratory artifacts | 540 | ||
| Future considerations | 540 | ||
| High-Resolution Impedance Manometry | 540 | ||
| Three-Dimensional Manometry | 540 | ||
| Summary | 541 | ||
| References | 541 | ||
| The Chicago Classification of Motility Disorders | 545 | ||
| Key points | 545 | ||
| Introduction | 546 | ||
| Metrics and swallow pattern characterization | 546 | ||
| Esophagogastric Junction Morphology and Deglutitive Relaxation | 546 | ||
| Deglutitive Peristaltic Vigor and Pattern | 548 | ||
| Intrabolus Pressure Pattern | 552 | ||
| Disorders with EGJ outflow obstruction | 552 | ||
| Major motility disorders | 554 | ||
| Aperistalsis | 554 | ||
| Distal Esophageal Spasm | 554 | ||
| Jackhammer Esophagus | 554 | ||
| Minor motility disorders | 556 | ||
| Peristaltic Abnormalities as Defined in the 2012 Chicago Classification | 556 | ||
| Limitations of the 2012 Chicago Classification | 557 | ||
| Minor Motility Disorders Proposed for Chicago Classification v3.0 | 557 | ||
| Ineffective Esophageal Motility | 557 | ||
| Fragmented Peristalsis | 558 | ||
| Normal Esophageal Motility | 558 | ||
| What is in the future? | 558 | ||
| Acknowledgments | 558 | ||
| References | 559 | ||
| The Role of Barium Esophagography in an Endoscopy World | 563 | ||
| Key points | 563 | ||
| Introduction | 563 | ||
| Terminology | 563 | ||
| Video Swallow Study | 564 | ||
| Esophagram | 564 | ||
| Performance of the examination | 564 | ||
| Theoretic advantages of radiography compared with endoscopy | 564 | ||
| The use of barium esophagography in specific esophageal disorders | 566 | ||
| Oropharyngeal Dysfunction | 566 | ||
| Zenker Diverticulum | 567 | ||
| Gastroesophageal Reflux Disease | 567 | ||
| Schatzki Ring | 569 | ||
| Postfundoplication Syndromes | 570 | ||
| Achalasia | 572 | ||
| Stricturing diseases | 574 | ||
| EoE | 574 | ||
| Lichen Planus | 575 | ||
| Caustic Injury | 575 | ||
| Esophageal Perforation | 576 | ||
| Esophageal Disorders Owing to Vascular Compression | 576 | ||
| Miscellaneous Disorders | 577 | ||
| Use of barium to describe esophageal physiology | 579 | ||
| Summary | 579 | ||
| References | 579 | ||
| Ambulatory Esophageal pH Monitoring | 581 | ||
| Key points | 581 | ||
| Introduction | 581 | ||
| Esophageal pH monitoring: what, why, and when | 582 | ||
| Test selection | 584 | ||
| Test interpretation | 586 | ||
| Current controversies | 590 | ||
| pH Electrode Placement Location | 590 | ||
| Discrepancy Between the Two Systems | 591 | ||
| The Influence of Diet on Test Accuracy | 591 | ||
| On or Off PPI Therapy | 592 | ||
| Summary and future directions | 592 | ||
| References | 592 | ||
| Evaluating Esophageal Bolus Transit by Impedance Monitoring | 595 | ||
| Key points | 595 | ||
| Introduction | 595 | ||
| Validation of impedance measurements to assess esophageal bolus transit | 596 | ||
| Conventional impedance manometry | 598 | ||
| High-resolution impedance manometry | 600 | ||
| Summary | 604 | ||
| References | 604 | ||
| Measuring Mechanical Properties of the Esophageal Wall Using Impedance Planimetry | 607 | ||
| Key points | 607 | ||
| Introduction | 607 | ||
| Earlier methods to measure distensibility | 608 | ||
| Principle of impedance planimetry | 609 | ||
| Functional luminal imaging and EGJ disease | 610 | ||
| Healthy Volunteers | 610 | ||
| GERD | 610 | ||
| Functional measurement | 611 | ||
| Intraoperative measurement | 611 | ||
| Achalasia | 612 | ||
| Intraoperative measurement | 612 | ||
| Functional measurement | 613 | ||
| Therapeutic use of impedance planimetry | 613 | ||
| Functional luminal imaging and esophageal body disease | 614 | ||
| Eosinophilic Esophagitis | 614 | ||
| Systemic Sclerosis | 616 | ||
| Functional luminal imaging and the upper esophageal sphincter | 616 | ||
| Summary | 617 | ||
| References | 617 | ||
| Evaluation of Esophageal Sensation | 619 | ||
| Key points | 619 | ||
| Introduction | 619 | ||
| Neurophysiology of the esophagus | 620 | ||
| Gastrointestinal sensitivity and gastroesophageal reflux disease | 621 | ||
| Esophageal sensitivity testing | 621 | ||
| Esophageal Manometry and 24-Hour Esophageal pH/Impedance | 621 | ||
| Provocative Esophageal Perfusion Testing | 622 | ||
| Noncardiac Chest Pain Provocative Testing | 623 | ||
| Provocative Barostat Balloon Testing | 623 | ||
| Impedance Planimetry | 625 | ||
| Multimodal Esophageal Assessment | 626 | ||
| Esophageal Evoked Potentials | 626 | ||
| Brain Imaging | 627 | ||
| Immunologically Mediated Sensory Pathways | 628 | ||
| Implications for Esophageal Sensory Testing in Understanding the Pathophysiology of Esophageal Disease and in Drug Development | 629 | ||
| Current Clinical Assessment Recommendations | 629 | ||
| References | 630 | ||
| Utilization of Esophageal Function Testing for the Diagnosis of the Rumination Syndrome and Belching Disorders | 633 | ||
| Key points | 633 | ||
| Introduction | 633 | ||
| The rumination syndrome | 634 | ||
| Pathophysiology | 634 | ||
| Clinical Evaluation and Diagnostic Approach | 634 | ||
| Treatment | 635 | ||
| Belching disorders | 637 | ||
| Pathophysiology | 637 | ||
| Clinical Evaluation and Diagnostic Approach | 637 | ||
| Treatment | 639 | ||
| Summary | 640 | ||
| References | 640 | ||
| Uses of Esophageal Function Testing | 643 | ||
| Key points | 643 | ||
| Introduction | 643 | ||
| Dysphagia associated with esophageal motility disorders defined in the Chicago Classification | 644 | ||
| Achalasia | 644 | ||
| Persistent Dysphagia After Treatment in Achalasia | 645 | ||
| EGJ Outflow Obstruction | 646 | ||
| Distal Esophageal Spasm | 646 | ||
| Hypercontractile Esophagus | 647 | ||
| Esophageal Hypomotility | 648 | ||
| Investigation of dysphagia resulting from other causes | 649 | ||
| Dysphagia with Normal Esophageal Peristalsis on Wet Swallows | 649 | ||
| Dysphagia Following Antireflux Surgery | 650 | ||
| Functional Dysphagia | 651 | ||
| Diagnostic flowchart | 652 | ||
| References | 652 | ||
| Diagnostic Work-Up of GERD | 655 | ||
| Key points | 655 | ||
| Introduction | 655 | ||
| Diagnosing GERD by symptoms and response to acid suppression | 656 | ||
| Esophagram and esophageal manometry | 658 | ||
| Endoscopic evaluation and role of esophageal biopsies | 658 | ||
| Reflux monitoring | 658 | ||
| Catheter-Based and Wireless pH Monitoring | 659 | ||
| Impedance-pH Monitoring | 659 | ||
| Beyond Reflux Burden: Symptom Association Studies During Reflux Monitoring | 660 | ||
| Work up of patients with PPI-refractory symptoms | 661 | ||
| Summary | 663 | ||
| References | 663 | ||
| Esophageal Function Testing | 667 | ||
| Key points | 667 | ||
| Introduction | 667 | ||
| Ultrasound imaging of esophagus | 668 | ||
| Static US imaging | 669 | ||
| Muscle Hypertrophy in Esophageal Motor Disorders and Its Significance | 669 | ||
| Dynamic US imaging | 671 | ||
| Patterns of Longitudinal Muscle Contraction in Health and Their Significance to Normal Esophageal Function | 671 | ||
| Patterns of longitudinal muscle contraction in the diseased states | 673 | ||
| Luminal distension measurement by US imaging and impedance recordings | 677 | ||
| Laser Doppler flowmetry to measure esophageal wall blood perfusion | 681 | ||
| Summary | 681 | ||
| References | 682 | ||
| Index | 687 |