Utility of non-endoscopic investigations in the practical management of oesophageal disorders

作者：Sifrim Daniel^*; Blondeau Kathleen; Mantillla Lidia

来源：Best Practice & Research in Clinical Gastroenterology, 2009, 23(3): 369-386.

DOI：10.1016/j.bpg.2009.03.005

• gastro-oesophageal reflux
• heartburn
• pH-metry
• oesophageal impedance oesophageal motility
• dysphagia
• non-cardiac chest pain
• high-resolution manometry
• oesophageal ultrasound

The current available methods for diagnosis of GORD are symptom questionnaires, catheter and wireless pH-metry, impedance-pH monitoring and Bilitec(@). Osophageal pH monitoring allows both quantitative analysis of acid reflux and assessment of reflux-symptom association. Impedance-pH monitoring detects all types of reflux (acid and non-acid) and allows assessment of proximal extent of reflux, a relevant parameter for understanding symptoms perception and extraoesophageal symptoms. Bilitec provides a quantitative assessment of duodeno-gastro-oesophageal reflux. Oesophageal motor abnormalities have been associated with GORD symptoms as well as chest pain and dysphagia. High-resolotion manometry contributed to re-classify oesphageal motor disorders. However, barium swallows are still essential for evaluation of oesophageal anatomy and combined oesophageal manometry-impedance can assess oesophageal motility and bolus transit simultaneously in a non-radiological way. Still in experimental phase, high-frequency ultrasound allows monitoring of the oesophageal wall thickness and exaggerated longitudinal muscle contraction that might be associated to chest pain and dysphagia. This chapter provides a critical evaluation of the clinical application of these techniques.

• 出版日期2009-6