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The patient will be asked at times to take a deep breath or to take some swallows of water. The degree of discomfort varies among patients. Patients are not sedated because sedatives would alter the functioning of the esophageal muscles. Overall the procedure takes about 45 minutes.
The diagnosis is made by an esophageal motility study (esophageal manometry), which evaluates the pressure of the esophagus at various points along its length. The term "nutcracker esophagus" comes from the finding of increased pressures during peristalsis , with a diagnosis made when pressures exceed 180 mmHg; this has been likened to the ...
The diagnosis is generally confirmed by esophageal manometry. [2] DES is present when more than a fifth of swallows results in distal esophageal contractions. [2] NE is present if the average strength of the contractions of the distal esophagus is greater than 180 mmHg but the contraction of the esophagus is otherwise normal. [2]
Gastric ulcer with a red spot seen in gastroscopy of a patient with upper gastrointestinal hemorrhage Successful closure of the gastric ulcer with an endoclip. The endoclip was first described by Hayashi and Kudoh in 1975, [1] and was termed the "staunch clip".
High-resolution manometry (HRM) is a gastrointestinal motility diagnostic system that measures intraluminal pressure activity in the gastrointestinal tract using a series of closely spaced pressure sensors. For a manometry system to be classified as "high-resolution" as opposed to "conventional", the pressure sensors need to be spaced at most 1 ...
An esophageal motility disorder (EMD) is any medical disorder resulting from dysfunction of the coordinated movement of esophagus, which causes dysphagia (i.e. difficulty in swallowing, regurgitation of food). [1] Primary motility disorders are: [1] Achalasia; Diffuse esophageal spasm; Nutcracker esophagus; Hypertensive lower esophageal sphincter
Most patients tolerate the procedure with only topical anesthesia of the oropharynx using lidocaine spray. However, some patients may need sedation and the very anxious/agitated patient may even need a general anesthetic. Informed consent is obtained before the procedure. The main risks are bleeding and perforation.
The procedure can be used to diagnose many disorders through direct visualization or tissue biopsy including esophageal varices, esophageal strictures, gastroesophageal reflux disease, Barrett's esophagus, cancer, celiac disease, gastritis, peptic ulcer disease, and a H. pylori infection.