Whether pH-metry and investigation of esophageal motor function are necessary for diagnosis and choice of therapy for us today?
Abstract
The aim of the publication. To describe various methods of pH-metry and investigation of motor function of the esophagus, to expose a role of these methods for diagnosis statement and choice of treatment.
Original positions. Studying of motor function of the esophagus allows to obtain data on intraluminal pressure, coordination and motility of muscles of the esophagus, to carry out differential diagnostics of primary and secondary disorders of this function, differential diagnostics at chest pain of non-cardiac origin, to reveal and estimate defects of peristalsis before antireflux surgery and after surgical intervention, to estimate efficacy of carried out treatment. Manometry is an auxiliary method at carrying out of 24-hour pHmetry of the esophagus as well. 24-hour (or 48-hour) pH-metry is «the gold standard» diagnostics of GERD. Impedance measurement method allows to observe bolus passage in the esophagus without application of X-ray investigation and irradiating of patients, to establish physical properties of refluxate (gas, fluid, mixed), that is important at a choice of treatment.
Conclusion. Disorders of esophageal motility can be revealed by various systems of monitoring. Nowadays manometry is informative and available diagnostic method for a doctor. Assessment of physical and chemical properties of refluxate and parameters of peristalsis of the esophagus is necessary for establishment of etiology and pathogenesis of diseases that allows to prescribe specific treatment to the patient.
About the Authors
O. A. StoronovaRussian Federation
A. S. Trukhmanov
Russian Federation
V. T. Ivashkin
Russian Federation
References
1. Артемьев А.С., Михеев А.Г., Мишулин Л.Е. и др. Импедансометрия пищевода: Сб. докл. науч.-технич. конф. «Медико-технические технологии на страже здоровья». Тунис, 2008. – М.: МГТУ им. Н.Э. Баумана. – 2008. – 204 с.
2. Болезни пищевода / Под ред. В.Т. Ивашкина, А.С. Трухманова. – М.: Триада-Х, 2000. – 179 с.
3. Бордин Д.С., Валитова Э.Р. Методика проведения и клиническое значение манометрии пищевода: Метод. рекомендации (№ 50). – М., 2009. – 23 с.
4. Васильев В.А., Попова Т.С., Тропская Н.С. Оценка двигательной активности органов желудочно-кишечного тракта // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 1995. – Т. 5, № 4. –C. 48–54.
5. Трухманов А.С. Гастроэзофагеальная рефлюксная болезнь: клинические варианты, прогноз, лечение: Автореф. ... д-ра мед. наук. – М., 2008. – 41 с.
6. Чернякевич С.А. Моторная функция верхних отделов пищеварительного тракта в норме и при патологии. // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 1998. – Т. 8, № 2. – С. 33–40.
7. Чернякевич С.А., Степнов М.В. Функциональное состояние нижнего пищеводного сфинктера (НПС) при гастроэзофагеальной рефлюксной болезни (ГЭРБ). Тезисы доклада на Двенадцатой Российской Гастроэнтерологической Неделе. Москва, 2006 // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2006. – Т. 16, № 5. – С. 14.
8. Castell D.O., Tutuian R. Diagnosis of GERD: Multichannel intraluminal impedance // Practical Gastroenterol. – March 2005. – P. 13–29.
9. Devault K.R. Esophageal pH and motility testing // AGA Institute Postgraduate Course. – May 30–31. – 2009.
10. Diener U., Patti M.G. et. al. Esophageal dysmotility and gastroesophageal reflux disease // J. Gastrointest. Surg. – 2001. – Vol. 5, N 3. – P. 260–265.
11. Fibbe C., Layer P. et al. Esophageal motility in reflux disease before and after fundoplication: A prospective, randomized, clinical, and manometric study // Gastroenterology. – 2001. – Vol. 121. – P. 5–14.
12. Ikuo Hirano, Tatum R.P. et al. Manometric heterogeneity in patients with idiopathic achalasia // Gastroenterology. – 2001. – Vol. 120. – P. 789–798.
13. Spechler S.J., Castell D.O. Classification of esophageal motility abnormalities // Gut. – 2001. – Vol. 49. – P. 145–151.
14. Tutuian R., Castell D.O. Multichannel intraluminal impedance: General principles and technical issues // Gastrointest. Endosc. Clin. N. Am. – 2005. – Vol. 15. – P. 257–264.
15. Tutuian R., Castell D.O. Reflux monitoring: Role of combined multichannel intraluminal impedance and pH // Gastrointest. Endosc. Clin. N. Am. – 2005. – Vol. 15. – P. 361–371.
Review
For citations:
Storonova O.A., Trukhmanov A.S., Ivashkin V.T. Whether pH-metry and investigation of esophageal motor function are necessary for diagnosis and choice of therapy for us today? Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(2):73-83. (In Russ.)
Views:
64
Email this article 
