Ciriza de los Ríos, Constanza Canga Rodríguez-Valcárcel, Fernando Castel de Lucas, Isabel Lora Pablos, David Cruz Bértolo, Javier de la Castellano Tortajada, Gregorio
Utilidad de la manometría de alta resolución en el diagnóstico
de la disrupción de la unión gastroesofágica: causas que influyen
en su disrupción y asociación con reflujo gastroesofágico y
alteraciones manométricas. [artículo] - Revista española de enfermedades digestivas : órgano oficial de la Sociedad Española de Patología Digestiva, 2014 - 106(1)22-9.
Formato Vancouver:
Ciriza de los Ríos C, Canga Rodríguez-Valcárcel F, Castel de Lucas I, Castellano Tortajada G. Utilidad de la manometría de alta resolución en el diagnóstico de la disrupción de la unión gastroesofágica: causas que influyen en su disrupción y asociación con reflujo gastroesofágico y alteraciones manométricas. Rev Esp Enferm Dig. 2014 Jan;106(1)22-9.
PMID: 24689712
Contiene 21 referencias
Background: High-resolution manometry (HRM) is a
breakthrough in the morphological study of the gastroesophageal junction (GEJ) and its degrees of disruption.
Objectives: a) Assessment of risk factors involved in the
disruption of the GEJ in patients with gastroesophageal reflux (GER)
symptoms; b) the relationship between the type of GEJ and GER
demonstrated by 24 hours pH-monitoring; and c) identification
of the alterations in the manometric parameters related to the
morphology of the GEJ.
Methods: One hundred and fifteen patients with symptoms of
GER studied with HRM and classified by the type of GEJ (type I: Normal; type II: Sliding; type III: Hiatal hernia). Twenty four hour pH-monitoring without proton pump inhibitors was performed in all of them. Epidemiological aspects, manometric parameters (Chicago 2012 classification) and the pH-onitoring results were evaluated.
Results: Age (OR 1.033 [1.006-1.060]; p = 0.16), BMI (OR
1.097 [1.022-1.176]; p = 0. 01) and abdominal perimeter (OR
1.034 [1.005-1.063]; p = 0.0215) were independent risk factors
for the GEJ type III (area under the curve 0.70). Disruption of the GEJ was associated with a lower resting pressure (p = 0.006), greater length (p < 0.001) and greater esophageal shortening (p < 0.001). Abnormal acidic reflux was found in the total period (p = 0.015), standing (p = 0.022) and supine (p = 0.001) in patients with GEJ type II and III with respect to type I.
Conclusions: Increased age, overweight and central
obesity pose a higher risk of GEJ type III (hiatal hernia). The
greater disruption of the GEJ is associated with lower resting
pressure, esophageal shortening, and higher acid exposure in the pH-monitoring.
Utilidad de la manometría de alta resolución en el diagnóstico
de la disrupción de la unión gastroesofágica: causas que influyen
en su disrupción y asociación con reflujo gastroesofágico y
alteraciones manométricas. [artículo] - Revista española de enfermedades digestivas : órgano oficial de la Sociedad Española de Patología Digestiva, 2014 - 106(1)22-9.
Formato Vancouver:
Ciriza de los Ríos C, Canga Rodríguez-Valcárcel F, Castel de Lucas I, Castellano Tortajada G. Utilidad de la manometría de alta resolución en el diagnóstico de la disrupción de la unión gastroesofágica: causas que influyen en su disrupción y asociación con reflujo gastroesofágico y alteraciones manométricas. Rev Esp Enferm Dig. 2014 Jan;106(1)22-9.
PMID: 24689712
Contiene 21 referencias
Background: High-resolution manometry (HRM) is a
breakthrough in the morphological study of the gastroesophageal junction (GEJ) and its degrees of disruption.
Objectives: a) Assessment of risk factors involved in the
disruption of the GEJ in patients with gastroesophageal reflux (GER)
symptoms; b) the relationship between the type of GEJ and GER
demonstrated by 24 hours pH-monitoring; and c) identification
of the alterations in the manometric parameters related to the
morphology of the GEJ.
Methods: One hundred and fifteen patients with symptoms of
GER studied with HRM and classified by the type of GEJ (type I: Normal; type II: Sliding; type III: Hiatal hernia). Twenty four hour pH-monitoring without proton pump inhibitors was performed in all of them. Epidemiological aspects, manometric parameters (Chicago 2012 classification) and the pH-onitoring results were evaluated.
Results: Age (OR 1.033 [1.006-1.060]; p = 0.16), BMI (OR
1.097 [1.022-1.176]; p = 0. 01) and abdominal perimeter (OR
1.034 [1.005-1.063]; p = 0.0215) were independent risk factors
for the GEJ type III (area under the curve 0.70). Disruption of the GEJ was associated with a lower resting pressure (p = 0.006), greater length (p < 0.001) and greater esophageal shortening (p < 0.001). Abnormal acidic reflux was found in the total period (p = 0.015), standing (p = 0.022) and supine (p = 0.001) in patients with GEJ type II and III with respect to type I.
Conclusions: Increased age, overweight and central
obesity pose a higher risk of GEJ type III (hiatal hernia). The
greater disruption of the GEJ is associated with lower resting
pressure, esophageal shortening, and higher acid exposure in the pH-monitoring.
