Esophageal motility study - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Instrumental

imaging studies are mandatory for the diagnosis of esophageal diseases.These include esophagoscopy and gastroscopy (FEGDS).But, in spite of the quality inspection of the mucous membrane of the body, these methods can not provide complete information on the functioning of the esophageal muscles, which are responsible for the proper movement of food in the stomach.Consequently, physicians frequently resort to such a diagnosis method as esophageal motility study, or, in other words, by measuring the pressure in the esophageal lumen.

esophageal motility study - is instrumental examination of the esophagus, which consists in the introduction through the mouth water - perfusion catheter, defining the pressure created his wall and the sphincter, and the nature of their peristalsis (successive contractions).

This method is the "gold standard" in the diagnosis of diseases associated with impaired motor skills motor function.However, the research methodology is quite complex and requires a fixed location of t

he sensor in the study area, as otherwise the results may be distorted.In addition to water - perfusion catheters can be used solid, but limit their use due to high costs.

Despite the technical complexity, the information obtained during the study correctly by a qualified specialist, is reliable, and plays a significant role in the proper diagnosis of esophageal motility disorders.

Indications.

esophageal motility study is indicated for suspected following diseases:
- gastroesophageal reflux disease,
- achalasia,
- diffuse esophageal spasm,
- congenital malformations of pharynx structure,
- control after surgery for the above diseases, if there is need for surgery.

Contraindications.

Carrying esophageal motility study is contraindicated in conditions such as:

- acute infectious diseases, fever,
- a chemical burn of the esophagus, acute esophagitis,
- inflammation of the esophagus diverticulum (diverticulitis), esophageal varices in cirrhosis of the liver, tumors andesophagus adhesions,
- serious diseases of internal organs - heart, respiratory failure, myocardial infarction, bronchial asthma in the acute stage, acute stroke, etc.,
- mental disorders,
- drunkenness,
- exacerbation of chronic diseases - pancreatitis, cholecystitis, etc..

Preparation for the study.

eve of research should be excluded food intake for 10 hours before the procedure, you can not drink alcohol and smoke.Also not recommended for oily, spicy, spicy food.The liquid can not be taken for three hours before the procedure.

Generally, the physician of the patient prevents that during the day before the test, it should cancel taken drugs, such as nitroglycerine and analogs thereof, omeprazole motilium, theophylline, etc., since they may affect the esophageal muscle tone.

Study.

esophageal motility study can be carried out both in the clinic and in the hospital.After the conversation with the doctor, explains the essence of the procedure, the patient is invited to take a comfortable position sitting in a chair.A doctor holds oropharyngeal anesthesia using irrigation lidocaine or tetracaine and begins to introduce a catheter through the mouth or nose.The latter method is preferable, since it significantly reduces the discomfort.

After introducing the catheter into the stomach via the analyzing unit (computer) is fixed to the pressure lower esophageal sphincter.At this stage it is important to follow the doctor's team, for example, to make swallowing movement during insertion of the catheter and hold your breath while pulling the catheter from the stomach up into the lower sphincter.Then the patient is offered via syringe 5 ml of water swallow, and to make the so-called "wet sip".This is repeated three to five times for the registration of more pressure indicators in the sphincter.

Similarly, as pulling the catheter above the fixed pressure without a sip, sip during the dry (without water), and during the wet sip from three to five times.Thus, pressure is recorded at rest and at the time of advancing water in the lower sphincter in several zones over the esophagus and the upper esophageal sphincter.Further, the catheter is removed, and all computer data is analyzed.

duration of the study is 25-30 minutes, after which the patient is asked to expect results.Discomfort may occur during insertion of the catheter in the form of the urge to vomit, but they are stopped successfully, if quietly and evenly breathe and listen to team doctor.For three or four hours after the procedure probably soreness in the chest and coughing going on their own.

Explanation esophageal motility study results.

The study can be obtained data indicating normal esophageal motility, or abnormal.The latter include the absence of peristalsis, uncoordinated motor skills, excessive or insufficient esophageal contractions.In this case, each of the studied area can be observed incomplete relaxation, elongated or short duration peristalsis wave, change in pressure, such as high (above 45 mm Hg) or low (less than 10 mm Hg) resting pressure of the lower esophageal sphincter and t. d. interpret these results should only be a specialist.

complications.

As a result of violations of technology introduction of the catheter may cause bleeding from the nose, vomiting, introducing the catheter into the trachea instead of the esophagus, the perforation of the wall of the esophagus.Due to mechanical stimulation of the vagus nerve may develop reflex response from the other organs - bronchial spasm, irregular heartbeat, loss of consciousness.In the entire history of esophageal motility study described complications occurred in isolated cases.

therapists Sazykina OJ