TY - JOUR
T1 - Classification of esophageal motor findings in gastro-esophageal reflux disease: Conclusions from an international consensus group
AU - Gyawali, C. P.
AU - Roman, S.
AU - Bredenoord, A. J.
AU - Fox, M.
AU - Keller, J.
AU - Pandolfino, J. E.
AU - Sifrim, D.
AU - Tatum, R.
AU - Yadlapati, R.
AU - Savarino, E.
AU - AUTHOR GROUP
AU - Azpiroz, Fernando
AU - Babaei, Arash
AU - Bhatia, Shobna
AU - Boeckxstaens, Guy
AU - Bor, Serhat
AU - Carlson, Dustin
AU - Castell, Donald
AU - Cicala, Michele
AU - Clarke, John
AU - de Bortoli, Nicola
AU - Drug, Vasile
AU - Frazzoni, Marzio
AU - Holloway, Richard
AU - Kahrilas, Peter
AU - Kandulski, Arne
AU - Katz, Phil
AU - Katzka, David
AU - Mittal, Ravinder
AU - Mion, Francois
AU - Novais, Luis
AU - Patel, Amit
AU - Penagini, Roberto
AU - Ribolsi, Mentore
AU - Richter, Joel
AU - Salvador, Renato
AU - Savarino, Vincenzo
AU - Serra, Jordi
AU - Schnoll-Sussman, Felice
AU - Smout, Andre
AU - Soffer, Edy
AU - Sweis, Rami
AU - Tack, Jan
AU - Tolone, Salvatore
AU - Tutuian, Radu
AU - Vaezi, Michael
AU - Vela, Marcelo
AU - Woodland, Philip
AU - Wu, Justin
AU - Xiao, Yinglian
AU - Zerbib, Frank
PY - 2017
Y1 - 2017
N2 - BackgroundHigh-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. MethodsFocused literature searches were conducted, evaluating pathophysiology of GERD with emphasis on HRM. The results were discussed with an international group of experts to develop a consensus on the role of HRM in GERD. A proposed classification system for esophageal motor abnormalities associated with GERD was generated. Key ResultsPhysiologic gastro-esophageal reflux is inherent in all humans, resulting from transient lower esophageal sphincter (LES) relaxations that allow venting of gastric air in the form of a belch. In pathological gastro-esophageal reflux, transient LES relaxations are accompanied by reflux of gastric contents. Structural disruption of the esophagogastric junction (EGJ) barrier, and incomplete clearance of the refluxate can contribute to abnormally high esophageal reflux burden that defines GERD. Esophageal HRM localizes the LES for pH and pH-impedance probe placement, and assesses esophageal body peristaltic performance prior to invasive antireflux therapies and antireflux surgery. Furthermore, HRM can assess EGJ and esophageal body mechanisms contributing to reflux, and exclude conditions that mimic GERD. Conclusions & InferencesStructural and motor EGJ and esophageal processes contribute to the pathophysiology of GERD. A classification scheme is proposed incorporating EGJ and esophageal motor findings, and contraction reserve on provocative tests during HRM
AB - BackgroundHigh-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. MethodsFocused literature searches were conducted, evaluating pathophysiology of GERD with emphasis on HRM. The results were discussed with an international group of experts to develop a consensus on the role of HRM in GERD. A proposed classification system for esophageal motor abnormalities associated with GERD was generated. Key ResultsPhysiologic gastro-esophageal reflux is inherent in all humans, resulting from transient lower esophageal sphincter (LES) relaxations that allow venting of gastric air in the form of a belch. In pathological gastro-esophageal reflux, transient LES relaxations are accompanied by reflux of gastric contents. Structural disruption of the esophagogastric junction (EGJ) barrier, and incomplete clearance of the refluxate can contribute to abnormally high esophageal reflux burden that defines GERD. Esophageal HRM localizes the LES for pH and pH-impedance probe placement, and assesses esophageal body peristaltic performance prior to invasive antireflux therapies and antireflux surgery. Furthermore, HRM can assess EGJ and esophageal body mechanisms contributing to reflux, and exclude conditions that mimic GERD. Conclusions & InferencesStructural and motor EGJ and esophageal processes contribute to the pathophysiology of GERD. A classification scheme is proposed incorporating EGJ and esophageal motor findings, and contraction reserve on provocative tests during HRM
U2 - https://doi.org/10.1111/nmo.13104
DO - https://doi.org/10.1111/nmo.13104
M3 - Review article
C2 - 28544357
SN - 1350-1925
VL - 29
SP - e13104
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 12
ER -