1. Devices for esophageal function testing
- Author
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Nikhil A. Kumta, Vinay Chandrasekhara, Rabindra R. Watson, Arvind J. Trindade, Joshua Melson, Barham K. Abu Dayyeh, Rahul Pannala, Monica Saumoy, John T. Maple, Marcelo F. Vela, Ryan J. Law, Amit Bhatt, Andrew Copland, Juan Carlos Bucobo, Guru Trikudanathan, Julie Yang, David R. Lichtenstein, Mansour A. Parsi, Erik F. Rahimi, Manoop S. Bhutani, Pichamol Jirapinyo, Amrita Sethi, and Kumar Krishnan
- Subjects
medicine.medical_specialty ,DRI, dysphagia risk index ,NOD, nonobstructive dysphagia ,CSA, cross-sectional area ,HRM, high-resolution esophageal manometry ,BMI, body mass index ,MSA, magnetic sphincter augmentation ,MEDLINE ,MII, multichannel intraluminal impedance ,Achalasia ,SI, Symptom index ,FLIP, functional luminal imaging probe ,Esophageal function ,POEM, peroral endoscopic myotomy ,Technology Status Evaluation Report ,Medicine ,Radiology, Nuclear Medicine and imaging ,EGJOO, esophagogastric junction outflow obstruction ,MRS, multiple rapid swallows ,EoE, eosinophilic esophagitis ,SAP, symptom association probability ,Esophagus ,DP, distensibility plateau ,Eosinophilic esophagitis ,business.industry ,CC, Chicago classification ,Gastroenterology ,CD, contractile deceleration ,PPI, proton pump inhibitors ,IRP, integrated relaxation pressure ,DI, distensibility index ,Dimension measurement ,medicine.disease ,IEM, ineffective esophageal motility ,AET, acid exposure time ,medicine.anatomical_structure ,Esophageal motility disorder ,EGJ, esophagogastric junction ,EPT, esophageal pressure topography plots ,EM, esophageal manometry ,UES, upper esophageal sphincter ,Radiology ,LES, lower esophageal sphincter ,ASGE, American Society for Gastrointestinal Endoscopy ,Anal sphincter ,business ,LHM, laparoscopic Heller myotomy - Abstract
Background and Aims Esophageal function testing is an integral component of the evaluation of refractory GERD and esophageal motility disorders. This review summarizes the current technologies available for esophageal function testing, including the functional luminal imaging probe (FLIP), high-resolution esophageal manometry (HRM), and multichannel intraluminal impedance (MII) and pH monitoring. Methods We performed a MEDLINE, PubMed, and MAUDE database literature search to identify pertinent clinical studies through March 2021 using the following key words: esophageal manometry, HRM, esophageal impedance, FLIP, MII, and esophageal pH testing. Technical data were gathered from traditional and web-based publications, proprietary publications, and informal communications with pertinent vendors. The report was drafted, reviewed, and edited by the American Society for Gastrointestinal Endoscopy Technology Committee and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy. Results FLIP is a high-resolution impedance planimetry system used for pressure and dimension measurement in the esophagus, pylorus, and anal sphincter. FLIP provides complementary information to HRM for esophageal motility disorders, especially achalasia. The Chicago classification, based on HRM data, is a widely adopted algorithmic scheme used to diagnose esophageal motility disorders. MII detects intraluminal bolus movement and, combined with pH measurement or manometry, provides information on acid and non-acid gastroesophageal reflux and bolus transit in patients with refractory GERD and for preoperative evaluation for anti-reflux procedures. Conclusions Esophageal function testing techniques (FLIP, HRM, and MII-pH) have diagnostic and prognostic value in the evaluation of esophageal motility disorders and refractory GERD. Newer technologies and classification systems have enabled an increased understanding of these diseases., Video Video 1 Endoscopic video of ENDOFLIP procedure.
- Published
- 2021