Abstract
Gastric and small bowel motor activity is less commonly evaluated. Such evaluations usually are conducted only at expert centers, because of a number of factors. The first is that the placement of manometry catheters into the small bowel requires either fluoroscopic or endoscopic guidance. As a word of caution, the delicate nature of modern high-resolution manometry catheters makes them highly susceptible to damage. Endoscopic placement can be quite traumatic to the solid-state sensors, leading to expensive repair. Secondly, the data acquisition is time-consuming and labor-intensive. The final factor is the greater expertise required for the interpretation of these studies, which are more complex than esophageal studies and have not been the subject of extensive literature.
Antroduodenal manometry (ADM) allows for evaluation of the gastric, duodenal, and proximal jejunal motor function. Typically, the manometry catheter is placed across the gastric pyloric channel. Extending into at least the proximal 20 cm of the small bowel allows simultaneous pressure measurements of both the antrum and the duodenum. Owing to the challenges of this measurement, few studies have assessed this technique in disease states. This chapter concentrates on normal ADM during fasting and post-prandial periods, as well as appropriate response to intravenous promotility agents (e.g., erythromycin) for provocative testing.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Frank JW, Sarr MG, Camilleri M. Use of gastroduodenal manometry to differentiate mechanical and functional intestinal obstruction: an analysis of clinical outcome. Am J Gastroenterol. 1994;89:339–44.
Castedal M, Björnsson E, Abrahamsson H. Effects of midazolam on small bowel motility in humans. Aliment Pharmacol Ther. 2000;14:571–7.
Gielkens HA, Verkijk M, Frölich M, Lamers CB, Masclee AA. Is the effect of acute hyperglycaemia on interdigestive antroduodenal motility and small-bowel transit mediated by insulin? Eur J Clin Invest. 1997;27:703–10.
Bortolotti M, Annese V, Coccia G. Twenty-four hour ambulatory antroduodenal manometry in normal subjects (co-operative study). Neurogastroenterol Motil. 2000;12:231–8.
Kellow JE, Borody TJ, Phillips SF, Tucker RL, Haddad AC. Human interdigestive motility: variations in patterns from esophagus to colon. Gastroenterology. 1986;91:386–95.
Holland R, Gallagher MD, Quigley EM. An evaluation of an ambulatory manometry system in assessment of antroduodenal motor activity. Dig Dis Sci. 1996;41:1531–7.
Björnsson ES, Abrahamsson H. Comparison between physiologic and erythromycin-induced interdigestive motility. Scand J Gastroenterol. 1995;30:139–45.
Chen JD, Lin ZY, Edmunds MC, McCallum RW. Effects of octreotide and erythromycin on gastric myoelectrical and motor activities in patients with gastroparesis. Dig Dis Sci. 1998;43:80–9.
Haruma K, Wiste JA, Camilleri M. Effect of octreotide on gastrointestinal pressure profiles in health and in functional and organic gastrointestinal disorders. Gut. 1994;35:1064–9.
Parthasarathy G, Ravi K, Camilleri M, Andrews C, Szarka LA, Low PA, et al. Effect of neostigmine on gastroduodenal motility in patients with suspected gastrointestinal motility disorders. Neurogastroenterol Motil. 2015;27:1736–46.
Little TJ, Pilichiewicz AN, Russo A, Phillips L, Jones KL, Nauck MA, et al. Effects of intravenous glucagon-like peptide-1 on gastric emptying and intragastric distribution in healthy subjects: relationships with postprandial glycemic and insulinemic responses. J Clin Endocrinol Metab. 2006;91:1916–23.
Näslund E, Gutniak M, Skogar S, Rössner S, Hellström PM. Glucagon-like peptide 1 increases the period of postprandial satiety and slows gastric emptying in obese men. Am J Clin Nutr. 1998;68:525–30.
Meier JJ, Gallwitz B, Salmen S, Goetze O, Holst JJ, Schmidt WE, Nauck MA. Normalization of glucose concentrations and deceleration of gastric emptying after solid meals during intravenous glucagon-like peptide 1 in patients with type 2 diabetes. J Clin Endocrinol Metab. 2003;88:2719–25.
Bharucha AE, Camilleri M, Low PA, Zinsmeister AR. Autonomic dysfunction in gastrointestinal motility disorders. Gut. 1993;34:397–401.
Verhagen MA, Samsom M, Jebbink RJ, Smout AJ. Clinical relevance of antroduodenal manometry. Eur J Gastroenterol Hepatol. 1999;11:523–8.
Samsom M, Jebbink RJ, Akkermans LM, Berge-Henegouwen GP, Smout AJ. Abnormalities of antroduodenal motility in type I diabetes. Diabetes Care. 1996;19:21–7.
Patcharatrakul T, Gonlachanvit S. Technique of functional and motility test: how to perform antroduodenal manometry. J Neurogastroenterol Motil. 2013;19:395–404.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Moosavi, S., Rezaie, A., Pimentel, M., Pichetshote, N. (2020). Antroduodenal Manometry. In: Atlas of High-Resolution Manometry, Impedance, and pH Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-27241-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-27241-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-27240-1
Online ISBN: 978-3-030-27241-8
eBook Packages: MedicineMedicine (R0)