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Esophageal Manometry

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Pediatric Neurogastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Esophageal manometry has been considered the “gold standard” test for the evaluation of esophageal motor function. At present, abnormal motor activity as measured by “conventional manometry” is defined in terms of a few basic patterns: incomplete sphincter relaxation, esophageal spasm, hypertensive contractions, and loss of tone and motility. Only achalasia and severe diffuse esophageal spasm are specific disorders with manometric abnormalities that are absent in healthy subjects. Other esophageal motility disorders are poorly defined, often include “abnormalities” that can be found in symptom-free individuals as well and are inconsistent over time. High-resolution manometry (HRM) was developed to increase interpretative consistency and diagnostic accuracy of esophageal manometry. One of the most important advantages of HRM is that it makes diagnostic esophageal manometry easier and quicker to perform. HRM identifies patients with poor coordination between the proximal and mid-esophagus (wide “transition zone”), focal hypotensive contractions, or focal spasm that would be missed by conventional manometry. Crucially, HRM can distinguish between abnormalities that disturb bolus transport from abnormalities that have no effect on function. HRM has been shown to increase diagnostic accuracy. Recently, Goldani et al. have illustrated the use of HRM in a pediatric age group while using a standardized protocol and analytical method. Despite the inherent limitations of the pediatric population, the authors introduced a new protocol in unsedated children in the context of a clinical setting, moving from research into clinical application. HRM may prove to have clinical advantages in pediatric patients as it has in adults, but further proof of its usefulness in these subjects will be required.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Naples, Naples, Italy

    Roberta Buonavolontà M.D.

  2. Department of Pediatrics, University of Naples Federico II, Naples, Italy

    Marina Russo M.D. & Rossella Turco M.D.

  3. Pediatric Gastoenterology Division, Pediatrics Department, University of Naples “Federico II”, via Pansini 5, Naples, 80131, Italy

    Annamaria Staiano M.D.

Authors
  1. Roberta Buonavolontà M.D.
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  2. Marina Russo M.D.
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  3. Rossella Turco M.D.
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  4. Annamaria Staiano M.D.
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Corresponding author

Correspondence to Annamaria Staiano M.D. .

Editor information

Editors and Affiliations

  1. Sainte-Justine Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Université de Montréal, Montreal, H3T 1C5, Québec, Canada

    Christophe Faure

  2. Nationwide Children's Hospital, Division of Pediatric Gastroenterology, The Ohio State University, Columbus, 43205, Ohio, USA

    Carlo Di Lorenzo

  3. Gastroenterology and Neural Development, University College London, Institute of Child Health, Great Ormond Street Hospital for Children, London, WC1N 1EH, United Kingdom

    Nikhil Thapar

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Buonavolontà, R., Russo, M., Turco, R., Staiano, A. (2013). Esophageal Manometry. In: Faure, C., Di Lorenzo, C., Thapar, N. (eds) Pediatric Neurogastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-709-9_8

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  • DOI: https://doi.org/10.1007/978-1-60761-709-9_8

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-708-2

  • Online ISBN: 978-1-60761-709-9

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