Esophageal motor abnormalities in gastroesophageal reflux disorders
| Autor: | Wei-Yi Lei, Chih-Hsun Yi, Tso-Tsai Liu, Jui-Sheng Hung, Ming-Wun Wong, Chien-Lin Chen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Tzu-Chi Medical Journal, Vol 36, Iss 2, Pp 120-126 (2024) |
| Druh dokumentu: | article |
| ISSN: | 1016-3190 2223-8956 85300152 |
| DOI: | 10.4103/tcmj.tcmj_209_23 |
| Popis: | Gastroesophageal reflux disease (GERD), a prevalent condition with multifactorial pathogenesis, involves esophageal motor dysmotility as a key contributing factor to its development. When suspected GERD patients have an inadequate response to proton-pump inhibitor (PPI) therapy and normal upper endoscopy results, high-resolution manometry (HRM) is utilized to rule out alternative diagnosis such as achalasia spectrum disorders, rumination, or supragastric belching. At present, HRM continues to provide supportive evidence for diagnosing GERD and determining the appropriate treatment. This review focuses on the existing understanding of the connection between esophageal motor findings and the pathogenesis of GERD, along with the significance of esophageal HRM in managing GERD patients. The International GERD Consensus Working Group introduced a three-step method, assessing the esophagogastric junction (EGJ), esophageal body motility, and contraction reserve with multiple rapid swallow (MRS) maneuvers. Crucial HRM abnormalities in GERD include frequent transient lower esophageal sphincter relaxations, disrupted EGJ, and esophageal body hypomotility. Emerging HRM metrics like EGJ-contractile integral and innovative provocative maneuver like straight leg raise have the potential to enhance our understanding of factors contributing to GERD, thereby increasing the value of HRM performed in patients who experience symptoms suspected of GERD. |
| Databáze: | Directory of Open Access Journals |
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