Manometry Flashcards
Surrogate for LES tone
Integrated relaxation pressure (IRP)
* Normal IRP <12
* Abnormal >12
Surrogates for peristalsis
- Distal contractile integral (DCI)
*normal 450<DCI <8000
*failed persitalsis <100
*incomplete parastalsis <450 - Distal Latency - normal >4.5 seconds
*DL <4.5sec = spasm
Failed or inadequate Peristalsis
Assuming IRP <12 -15
DCI <100= failed
Absent Contractility
DCI <450= incomplete
Ineffective esophageal motility
Hypercontractile Esophagus
DCI >8,000
normal IRP
What disorder this this?
Provocative test performed in EGJOO
FLIP topography - difference between normal response and EGJOO
FLIP - measures esophageal distensibility
What is the esophageal distensibility index (DI) in EGJOO?
What is the maximum EGJ diameter in EGJOO?
Distensibility index <2 suggested EGJOO
Max EGJ diameter <!2mm suggests EGJOO
What condition is this?
Type 1 Achalasia
elevated IRP >15
100% failed peristalsis
Treat with any definitive management
What condition is this?
Type 2 Achalasia
elevated IRP >15
pan esophageal pressurization
responds best to treatment
Treat with any definitive management
What condition is this?
Type 3 Achalasia
elevated IRP >15
premature contractions DL <4.5seconds
responds worse to treatment
Treat with POEM
What is the provocative test for ineffective esophageal motility?
List the Chicago Classification V4
Which conditions require symptoms to be present for diagnosis?
What is the criteria for EGJOO?
- elevated IRP
- preserved peristalsis
- increased intrabolus pressure
- symptoms
- abnormal barium or FLIP
What condition is this?
Ineffective esophageal motility
causes- scleroderma, diabetes, amyloid, RA
What condition is this?
elevated IRP
preserved peristalsis
increased intrabolus pressure
Also assumes the presence of:
-symptoms
-abnormal barium or FLIP
What condition is this?
What is this and what else do you need to make a diagnosis?
dyssynergistic defecation
also need failed balloon expulsion test
