High-resolution versus conventional manometry for the diagnosis of small bowel motor dysfunction
Alcalá González, Luis Gerardo (Vall d'Hebron Institut de Recerca (VHIR))
Nieto Ruiz, Adoración (Vall d'Hebron Institut de Recerca (VHIR))
Accarino, Ana María (Vall d'Hebron Institut de Recerca (VHIR))
Azpiroz Vidaur, Fernando (Vall d'Hebron Institut de Recerca (VHIR))
Malagelada Prats, Carolina (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2024
Resum:	Background: The diagnosis of small bowel motility disorders is performed by manometric evaluation of the contractile patterns of the small intestine. Conventional intestinal manometry systems include few pressure sensors at relatively long intervals. We have recently shown that high-resolution jejunal manometry, with multiple closely spaced recording sites, allows the analysis of propagation patterns of intestinal motility in healthy subjects that cannot be detected with conventional manometry. The objective of this pilot study was to explore the feasibility and diagnostic value of high-resolution intestinal manometry in patients with suspected small bowel dysmotility. Methods: Prospective pilot study evaluating intestinal motility patterns in 16 consecutive patients (16-61 years; 11 women) with severe, chronic digestive symptoms referred for the evaluation of intestinal motility and in 18 healthy controls (21-38 years; 8 women). A 36-channel high-resolution manometry catheter was orally placed under radiological guidance in the jejunum. Intestinal motility was continuously recorded for 3 h fasting and 2 h after a 450 kcal meal. The manometric recordings were analyzed in two formats: (a) with the high-resolution data from 34 channels and (b) showing only the recordings from 5 channels separated by 7 cm intervals, mimicking a conventional manometry recording. Key Results: In the analysis mimicking conventional manometry, abnormal motility criteria were detected in six patients and in no healthy subject [bursts (n = 3), postprandial minute rhythm (n = 1) and myopathic pattern (n = 2)]. These classical dysmotility criteria were also detected by high-resolution manometry. High-resolution analysis detected one or more abnormal findings in seven additional patients that were not observed in any healthy subject, specifically: (a) abnormal propagation of Phase III (n = 3); (b) reduced propagated activity during Fasting Phase II (n = 4); (c) increased propagated activity during Fasting Phase II and postprandial phase (n = 1). Conclusions and Inferences: This pilot study suggests that high-resolution intestinal manometry may improve the sensitivity of conventional manometry in the detection of intestinal motor dysfunction.
Ajuts:	Instituto de Salud Carlos III PI17/01794 Agencia Estatal de Investigación PID2021-122295OB-I00 Instituto de Salud Carlos III CM20/00182
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Intestinal dysmotility ; Pseudo-obstruction ; Small bowel manometry
Publicat a:	Neurogastroenterology & motility, Vol. 36, Núm. 11 (November 2024) , ISSN 1365-2982

DOI: 10.1111/nmo.14907

7 p, 3.2 MB

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