NORMAL VALUES OF ESOPHAGEAL HIGH-RESOLUTION MANOMETRY: A BRAZILIAN MULTICENTER STUDY.

Background: The high-resolution manometry has been a significant advance in esophageal diagnostics. There are different types of catheter and systems devices to capture esophageal pressures that generate variable data related to Chicago Classification (CC) and consequently influence normal values results. There are not normative data for the 24-channel water-perfused high-resolution manometry system most used in Brazil with healthy volunteers in supine posture.

Eosinophilic esophagitis: manometric and pHmetric findings.

Context: Eosinophilic esophagitis is an entity characterized by an esophageal inflammatory infiltrate of eosinophils, manifested by dysphagia, intermittent food impactions and symptoms similar to gastroesophageal reflux disease (GERD), that predominantly affects young adults. There may be association of eosinophilic esophagitis with GERD, and motor abnormalities have been described.

Objective: The main objectives of this study are to describe the findings at esophageal manometry and pH monitoring in patients with eosinophilic esophagitis.

Esophageal manometry findings and degree of acid exposure in short and long Barrett's esophagus.

Context: Barrett's esophagus (BE) is characterized by intestinal metaplasia in the distal esophagus and is classified as short-segment (<3 cm - SSBE) or long-segment (>3 cm - LSSBE). It is suggested that LSSBE is associated with more severe esophageal motor abnormalities and increased acid exposure time than SSBE.

Objective: To evaluate the prevalence of esophageal manometriy abnormalities and acid exposure times in patients with SSBE and LSSBE.

Achalasia in the elderly patient: a comparative study.

Context: Achalasia is a primary esophageal motor disorder secondary to the degeneration of ganglion cells of the inhibitory intramural myenteric plexus. It affects both sexes similarly and has two peaks of incidence, one in the 3rd to 4th decades of life and the other after 60 years of age. The effect of age on esophageal motility of patients with achalasia is not well known.

Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure.

Context: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research.

Objective: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea) and also the relevance of the vocal folds closure in this process.

Methods: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed.

[Higher prevalence of obesity in erosive gastroesophageal reflux disease].

Context: Weight loss is commonly recommended as a treatment for gastroesophageal reflux; however, a relationship between excessive body weight and gastroesophageal reflux disease is not well established.

Objectives: To evaluate the prevalence of obesity and over-weight in patients with heartburn, with and without erosive esophagitis; to analyze the prevalence of hiatal hernia and the intensity of abnormal gastroesophageal reflux in both groups of patients, and its relation to body mass index.

Methods: The data of pH monitoring of 362 individuals with heartburn were evaluated retrospectively.

Gastroesophageal reflux in cirrhotic patients with esophageal varices without endoscopic treatment.

Background: Portal hypertension in patients with liver cirrhosis causes manifestations such as esophageal varices, ascites and edema. Some studies have been conducted about the role of esophageal varices in the development of esophageal motor disorders and abnormal gastroesophageal reflux in these patients. Ascites could be a factor promoting gastroesophageal reflux and it has been questioned whether reflux would favor the rupture of varices.

[Prevalence of supraesophageal manifestations in patients with gastroesophageal erosive and non-erosive reflux disease].

Background: Respiratory, ear-nose and throat complaints, chest pain and dysphagia can be a part of clinical manifestations of gastroesophageal reflux disease. The first two are named supraesophageal manifestations of gastroesophageal reflux disease. Controversy about the prevalence of these clinical manifestations in patients with non-erosive and erosive gastroesophageal reflux disease exists.

Esophageal diverticula: pathogenesis, clinical aspects, and natural history.

It has been gradually accepted that esophageal diverticula result from esophageal motor disorders rather than from primary anatomic abnormalities. Twenty-seven patients with these diverticula were evaluated with respect to pathogenesis, clinical aspects, diagnostic tests, therapy, and natural history for a mean of 27 months of followup. Thirteen diverticula were midesophageal, 11 were situated in the distal third of the esophagus, and 3 were in both regions.

[Relationship between the size of hiatal hernia and esophageal acid exposure time in erosive and non-erosive reflux disease].

Background: In the last few years studies have demonstrated that hiatal hernias have an important role in the pathogenesis of reflux disease, promoting reflux by many different mechanisms, emphasizing that the larger the hiatal hernia, the higher the reflux intensity and erosive esophagitis prevalence.

Aim: To correlate the size of hiatal hernias (small or large) with reflux intensity (measured by pH monitoring parameters) in patients with non-erosive and erosive reflux disease.

Patients And Methods: We reviewed pH monitoring from patients with typical reflux symptoms (heartburn) previously submitted to upper endoscopy.

[Esophageal motor disorders in cirrhotic patients with esophageal varices non-submitted to endoscopic treatment].

Background: The hepatic cirrhosis has as one of the main morbid-mortality causes, the portal hypertension with the development of esophageal varices, the possibility of a digestive hemorrhage and worsening of hepatic insufficiency. It is important to identify causal predictive or aggravating factors and if possible to prevent them. In the last years, it has been observed the association of esophageal motor disorders and gastro-esophageal reflux in cirrhotic patients with esophageal varices.

[Role of esophageal provocative tests in the investigation of patients with chest pain of undetermined origin].

Background: Traditional methods employed in esophageal investigation of patients with chest pain of undetermined origin includes upper endoscopy, esophageal manometry and pH monitoring. These methods many times disclose abnormalities that can only be enrolled as the possible cause of chest pain. Provocative tests can reproduce pain in the laboratory, establishing its esophageal origin.

Ineffective esophageal motility in gastroesophageal erosive reflux disease and in nonerosive reflux disease: are they different?

Background: In GERD patients, ineffective esophageal motility (IEM), a hypocontractile disorder, is the most common motor abnormality. IEM has been associated with reflux in both the supine and upright position, prolonged esophageal clearance, and delayed of bolus transport. IEM has been equally present in erosive and in nonerosive GERD.

Characteristics of oesophageal bolus transport in patients with mild oesophagitis.

Objective: Patients with gastroesophageal reflux disease (GORD) frequently have oesophageal motility disturbance. However, detailed data about bolus transport characteristics in these patients are still lacking. In the present study the new technology of concurrent impedance manometry was applied for characterization of oesophageal motor function in patients with mild GORD.