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Mano-Impedancemetric Diagnosis of Esophageal Function in Children With Dyspepsia

https://doi.org/10.15690/pf.v15i5.1963

Abstract

Background. Introduction of new methods of diagnosing functional disorders of the upper gastrointestinal tract into children’s practice will reveal the true cause of changes in esophageal motility in its various pathologies, which will significantly change the treatment tactics, since the selection of therapy will be based on the pathogenetic mechanisms of disease development.

Our aim was to highlight the capabilities and benefits of high-resolution mano-impedancemetry in comparison with esophagogastroduodenoscopy, which has been studied and used in pediatric practice for a long time, and to prove that only due to a new method for diagnosing esophageal motility disorders, it is possible to determine the cause of dyspeptic complaints in children.

Patients and Methods. The results of our own examination of children aged from 7 to 17 years 11 months (n = 23) with clinical manifestations of functional disorders of the upper gastrointestinal tract have been presented.

Results. According to the mano-impedancemetry data, it has been found that the time of the substrate in the esophagus (p<0.02) and the speed of its passage through the esophagus depend on the pressure in the distal esophagus: the lower the pressure in the distal esophagus, the lower the fluid flow rate and the higher the degree of its reflux (р<0.001). Decreased speed indicates hypotonia of the lower esophagus and lower esophageal sphincter, which provides only a correction by physiotherapeutic treatment methods since surgical intervention in such conditions is ineffective.

Conclusion. The method of mano-impedancemetry allows to determine the indications for surgical treatment and to predict the efficacy of the conducted anti-reflux surgical correction.

About the Authors

Marina Ju. Stepanyan
SM-Clinic
Russian Federation
Moscow


Elena V. Komarova
National Medical Research Center for Children’s Health
Russian Federation
Moscow


Maksim M. Lohmatov
National Medical Research Center for Children’s Health
Russian Federation
Moscow


References

1. Klinicheskie rekomendatsii. Gastroezofageal’naya reflyuksnaya bolezn’ u detei [Internet]. Moscow: Soyuz pediatrov Rossii; 2018. (In Russ). Доступно по: http://www.pediatr-russia.ru/sites/default/files/file/kr_grb.pdf. Ссылка активна на 12.08.2018.

2. Ivashkin VT, Trukhmanov AS, Sheptulin AA, et al. Gastroezofageal’naya reflyuksnaya bolezn’. Rekomendatsii po diagnostike i lecheniyu. Moscow; 2013. 20 р. (In Russ).

3. Trukhmanov AS, Dzhakhaya NL, Kaibysheva VO, Storonova OA. Novye aspekty rekomendatsii po lecheniyu bol’nykh gastroezofageal’noi reflyuksnoi bolezn’yu. Gastroenterologiya i gepatologiya: novosti, mneniya, obuchenie. 2013;(1):2–9. (In Russ).

4. Bordin DS, Masharova AA. Diagnostika gastroezofageal’noi reflyuksnoi bolezni i lechenie lansoprazolom. Exp Clin Gastroenterol. 2008;(5):85–90. (In Russ).

5. Grishina EE, Rakhimov RR. Esophageal manometry in a complex examination of patients with gastroesophageal reflux disease before antireflux surgery. Bashkortostan medical journal. 2013;8(6):35–38. (In Russ).

6. Averin VI, Al’khimovich VN, Nikiforov AN. Gastroezofageal’nyi reflyuks u detei: uchebno-metodicheskoe posobie. 2nd ed. rev. Minsk; 2000. 27 h. (In Russ).

7. Shcherbakov PL. Gastroezofageal’nyi reflyuks u detei — aktual’naya problema detskoi gastroenterologii. Rus J Gastroenterol Hepatol Coloproctol. 2002;(1):62–67. (In Russ)

8. Zablodskii AN, Zueva LN. Endoskopicheskaya diagnostika neerozivnoi gastroezofageal’noi reflyuksnoi bolezni u detei. Exp Clin Gastroenterol. 2004;(1):157. (In Russ).

9. Krylov AYu. Fundamental’nye klinicheskie i farmatsevticheskie problemy patologii cheloveka. In: Sbornik trudov sotrudnikov Vitebskogo gos. med. un-ta. Vitebsk; 2003. рр. 360–363. (In Russ).

10. Bondarenko OYu, Zakharova NV, Ivashkin VT, et al. Dinamika simptomov i endoskopicheskoi kartiny pri standartnoi terapii gastroezofageal’noi reflyuksnoi bolezni. Rus J Gastroenterol Hepatol Coloproctol. 2005;15(1):40–45. (In Russ).

11. Valitova ER, Bordin DS, Yanova OB, et al. Funktsional’nye metody issledovaniya pishchevoda. Еxp Clin Gastroenterol. 2010;(10):71– 74. (In Russ).

12. Tutuian R, Castell DO. Review article: complete gastrooesophageal reflux monitoring — combined pH and impedance. Aliment Pharmacol Ther. 2006 24 Suppl 2:27–37. doi: 10.1111/j.1365-2036.2006.03039.x.

13. Kashkina EI. Diagnostika i lechenie gastroezofageal'noi reflyuksnoj bolezni [Internet]. Funktsional'naya gastroenterologiya. Istoksistema «GastroSkan»; 2018. (In Russ). Доступно по: http://www.gastroscan.ru/literature/authors/2257. Ссылка активна на 12.09.2018.

14. Сторонова О.А., Трухманов А.С. Методика изучения двигательной функции пищевода. Пособие для последипломного образования. / Под ред. акад. РАМН, проф. В.Т. Ивашкина. — М.; 2011. — 36 с. [Storonova O.A., Trukhmanov A.S. Metodika izucheniya dvigatel’noi funktsii pishchevoda. Posobie dlya poslediplomnogo obrazovaniya. Ed by akad. RAMN, prof. V.T. Ivashkina. Moscow: 2011. 36 p. (In Russ).

15. Ferris L, Rommel N, Doeltgen S, et al. Pressure — flow analysis for the assessment of pediatric oropharyngeal dysphagia. J Pediatr. 2016;177:279–285. doi: 10.1016/j.jpeds.2016.06.032.

16. Rommel N, Omari TI, Selleslagh M, et al. High-resolution manometry combined with impedance measurements discriminates the cause of dysphagia in children. Eur J Pediatr. 2015;174(12):1629–1637. doi: 10.1007/s00431-015-2582-9.

17. Трухманов А.С. Гастроэзофагеальная рефлюксная болезнь: клиника, диагностика, лечение // Русский медицинский журнал. Болезни органов пищеварения. — 2001. — Т.3. — №1 — C. 19–24. [Trukhmanov AS. Gastroezofageal’naya reflyuksnaya bolezn’: klinika, diagnostika, lechenie. Russkii meditsinskii zhurnal. Bolezni organov pishchevareniya. 2001;3(1):19–24. (In Russ).]

18. Pandolfino JE, Kahrilas PJ; American Gastroenterological Association. AGA technical review on the clinical use of esophageal manometry. Gastroenterology. 2005;128(1):209–224. doi: 10.1053/j.gastro.2004.11.008.

19. Holloway RH. Combined impedance-manometry for the evalution of esophageal disoders. Curr Opin Gastroenterol. 2014;30(4):422– 427. doi: 10.1097/MOG.0000000000000079.

20. Fox MR, Bredenoord AJ. Oesophageal high-resolution manometry — moving from research into clinical practice. Gut. 2008;57(3):405–423. doi: 10.1136/gut.2007.127993.

21. Kahrilas PJ, Ghosh SK, Pandolfino JE. Esophageal motility disorders in terms of pressure topography: the Chicago classification. J Clin Gastroenterol. 2008;42(5):627–635. doi: 10.1097/MCG.0b013e31815ea291.

22. Castell DO. The Esophagus. Ed by Castell DO, Richter JE. Fourth Edition; 2004. рр. 115–134.


Review

For citations:


Stepanyan M.J., Komarova E.V., Lohmatov M.M. Mano-Impedancemetric Diagnosis of Esophageal Function in Children With Dyspepsia. Pediatric pharmacology. 2018;15(5):402-409. (In Russ.) https://doi.org/10.15690/pf.v15i5.1963

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