Lower esophageal sphincter pressure measurement under standardized inspiratory maneuveurs. 2015

Jeany Borges e Silva Ribeiro, and Esther Cristina Arruda Oliveira Diógenes, and Patrícia Carvalho Bezerra, and Tanila Aguiar Andrade Coutinho, and Cícera Geórgia Félix de Almeida, and Miguel Ângelo Nobre e Souza
Laboratório de Gastroenterologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil.

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.

UI MeSH Term Description Entries
D008365 Manometry Measurement of the pressure or tension of liquids or gases with a manometer. Tonometry,Manometries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001239 Inhalation The act of BREATHING in. Inhaling,Inspiration, Respiratory,Respiratory Inspiration
D049630 Esophageal Sphincter, Lower The physiologic or functional barrier to GASTROESOPHAGEAL REFLUX at the esophagogastric junction. Sphincteric muscles remain tonically contracted during the resting state and form the high-pressure zone separating the lumen of the ESOPHAGUS from that of the STOMACH. (Haubrich et al, Bockus Gastroenterology, 5th ed., pp399, 415) Lower Esophageal Sphincter,Gastroesophageal Sphincter,Gastroesophageal Sphincters,Sphincter, Gastroesophageal,Sphincter, Lower Esophageal
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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