Utility of non-endoscopic investigations in the practical management of oesophageal disorders.
The current available methods for diagnosis of GORD are symptom questionnaires, catheter and wireless pH-metry, impedance-pH monitoring and Bilitec(@). Osophageal pH monitoring allows both quantitative analysis of acid reflux and assessment of reflux-symptom association. Impedance-pH monitoring detects all types of reflux (acid and non-acid) and allows assessment of proximal extent of reflux, a relevant parameter for understanding symptoms perception and extraoesophageal symptoms. Bilitec provides a quantitative assessment of duodeno-gastro-oesophageal reflux. Oesophageal motor abnormalities have been associated with GORD symptoms as well as chest pain and dysphagia. High-resolution manometry contributed to re-classify oesphageal motor disorders. However, barium swallows are still essential for evaluation of oesophageal anatomy and combined oesophageal manometry-impedance can assess oesophageal motility and bolus transit simultaneously in a non-radiological way. Still in experimental phase, high-frequency ultrasound allows monitoring of the oesophageal wall thickness and exaggerated longitudinal muscle contraction that might be associated to chest pain and dysphagia. This chapter provides a critical evaluation of the clinical application of these techniques.
Sifrim
Daniel
D
Center for Gastroenterological Research, Catholic University of Leuven, Belgium. daniel.sifrim@med.kuleuven.ac.be
Blondeau
Kathleen
K
Mantillla
Lidia
L
D004931:Esophageal Achalasia / Q000175:diagnosis; D004935:Esophageal Diseases / Q000150:complications / Q000175:diagnosis*; D004940:Esophageal Stenosis / Q000150:complications; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008365:Manometry; D018670:Monitoring, Ambulatory; D010528:Peristalsis / Q000502:physiology; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications