title: Lower esophageal sphincter pressure measurement under standardized inspiratory maneuveurs.
abstract: BACKGROUND
  Through rhythmic variations, the diaphragm influence lower esophageal sphincter (LES) pressure acting as an external sphincter. LES pressure recording is characterized by increased pressure in inspiration due to contraction of the diaphragmatic crura that involves the sphincter.
  
  
  OBJECTIVE
  To describe a method of measuring LES pressure during standardized inspiratory maneuvers with increasing loads.
  
  
  METHODS
  The study population comprised of eight healthy female volunteers (average age of 31.5 years). An esophageal high-resolution manometry and impedance system was used for measuring the LES pressure during 3-second inspiratory efforts under 12, 24 and 48 cm H2O loads (Threshold maneuvers).
  
  
  RESULTS
  There was a significant difference between the average maximum LES pressure and the average maximum basal LES pressure during the first (76.19±17.92 difference, p=0.0008), second (86.92±19.01 difference, p=0.0004), and third seconds of the maneuver (90.86±17.93 difference, p=0.0002), with 12, 24 and 48 cmH2O loads.
  
  
  CONCLUSIONS
  This maneuver is a standardization of the inspiratory LES pressure and may better differentiate patients with reflux disease from healthy individuals, and may also be useful for monitoring the treatment of these patients through inspiratory muscle training.
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Jeany Borges e Silva
authors.initials: JB
authors.lastname: Ribeiro
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Esther Cristina Arruda Oliveira
authors.initials: EC
authors.lastname: Diógenes
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Patrícia Carvalho
authors.initials: PC
authors.lastname: Bezerra
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Tanila Aguiar Andrade
authors.initials: TA
authors.lastname: Coutinho
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Cícera Geórgia Félix
authors.initials: CG
authors.lastname: de Almeida
authors.affiliation: Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Miguel Ângelo Nobre
authors.initials: MÂ
authors.lastname: e Souza
mesh_terms: D000328:Adult; D049630:Esophageal Sphincter, Lower / Q000502:physiology*; D005260:Female; D006801:Humans; D001239:Inhalation; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D055815:Young Adult