title: Double-peaked high-pressure zone at the esophagogastric junction in controls and in patients with a hiatal hernia: a study using high-resolution manometry.
abstract: The lower esophageal high-pressure zone (HPZ) consists of the intrinsic lower esophageal sphincter (LES) and the diaphragmatic sphincter. In patients with a hiatal hernia these constituents are separated. We performed high-resolution manometry of the esophagogastric HPZ in six controls, six patients with a small hernia, and six patients with a large hernia. Prevalence of a double-peak pressure profile of the HPZ was noted. Pressures and distances between the peaks were assessed. Prevalence of the double-peak profile was similar between patients with a small hernia and controls, but patients with a large hernia showed a higher prevalence with inspiration (P < 0.05) than the others. The distance between the two peaks was larger in patients with a large hernia (P < 0.05). In conclusion, high-resolution manometry makes it possible to distinguish the diaphragmatic pressure component from the LES. Two pressure peaks can be found both in hernia patients and in healthy volunteers.
authors.affiliation: Department of Gastroenterology, Sint Antonius Hospital, Nieuwegein, The Netherlands. a.bredenoord@antonius.net
authors.forename: A J
authors.initials: AJ
authors.lastname: Bredenoord
authors.forename: B L A M
authors.initials: BL
authors.lastname: Weusten
authors.forename: S
authors.initials: S
authors.lastname: Carmagnola
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
mesh_terms: D000328:Adult; D004943:Esophagogastric Junction / Q000502:physiology* / Q000503:physiopathology*; D005260:Female; D006551:Hernia, Hiatal / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged