Use of high-resolution colonic manometry to establish etiology and direct treatment in patients with constipation: Case series with correlation to histology

2018 ◽  
Vol 33 (11) ◽  
pp. 1864-1872 ◽  
Author(s):  
Yuwei Li ◽  
Jiying Cong ◽  
Fei Fei ◽  
Zhao Zhang ◽  
Yongjun Yu ◽  
...  
Keyword(s):  
High Resolution ◽  
Case Series ◽  
Direct Treatment ◽  
Colonic Manometry

scholarly journals A35 ASSOCIATIONS BETWEEN AUTONOMIC DYSFUNCTION, COLONIC DYSMOTILITY AND ABSENT DEFECATION REFLEXES IN PATIENTS WITH CHRONIC REFRACTORY CONSTIPATION

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 276-278
Author(s):  
L Liu ◽  
N Milkova ◽  
M Ali ◽  
K Sharma ◽  
J D Huizinga ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
High Resolution ◽  
Autonomic Dysfunction ◽  
Sympathetic Tone ◽  
Stress Index ◽  
Autonomic Reactivity ◽  
Autonomic Tone ◽  
Autonomic Nervous ◽  
Colonic Manometry

Abstract Background A defecation reflex involves sensory information from the colon sent to the central nervous system which results in propulsive motor patterns in the colon through programmed neural activity from the autonomic nervous system. Neurological causes of constipation are recognized but specific neurological pathways that contribute to pathophysiology of the disease is underexplored. Diagnosis and treatment usually do not involve the autonomic nervous system. Aims Our objective was to assess autonomic dysfunction and abnormal defecation reflexes as a possible cause of chronic constipation. Methods Defecation reflexes were assessed by high-resolution colonic manometry through balloon distention, meal intake, and rectal bisacodyl. Specific heart rate variability (HRV) parameters were used to assess general orthostatic autonomic reactivity, and autonomic functioning during high resolution colonic manometry, in 14 patients with chronic refractory constipation considered for surgery. Results All patients had a unique combination of motility, reflex ability and HRV profiles. Patients overall did not generate HAPWs or had lower HAPW amplitude and lower propulsive activity compared to healthy individuals. Half of the 14 patients were tested to have high sympathetic tone based on Baevsky’s stress index prior to HRCM, and 11 of the patients had sympathetic hyper-reactivity and/or low parasympathetic reactivity to at least one type of colonic stimulation during HRCM. Abnormal autonomic tone or autonomic reactivity to colonic stimulation was present in all four patients with absence of the vagosacral defecation reflex. Five of the seven patients with absence of the sacral defecation reflex showed high sympathetic tone or high sympathetic reactivity to stimulation. Only two patients had abnormality in coloanal coordination and this was associated with low parasympathetic reactivity to stimulation in both patients. Conclusions The assumption that colonic resection was needed to remove an inert colon was wrong in most patients, but most patients had some form of reflex abnormality. Sympathetic dominance far outweighed parasympathetic dysfunction. Incorporation of assessments of defecation reflexes and autonomic nervous system activity into diagnosis of chronic refractory constipation provides a comprehensive pathophysiological understanding of specific defective neurological pathways contributing to dysmotility. This forms the basis for our individualized treatment efforts through sacral neuromodulation. Funding Agencies CIHR

scholarly journals The Defecation Reflex Assessed by High-Resolution Colonic Manometry

2020 ◽  
Author(s):  
Ji-Hong Chen ◽  
Natalija Milkova ◽  
Lijun Liu ◽  
Jan D Huizinga
Keyword(s):  
High Resolution ◽  
Colonic Manometry

scholarly journals A288 ANAL SPHINCTER RELAXATION ASSOCIATED WITH THE DEFECATION REFLEX AND GAS EXPULSION, ASSESSED BY HIGH-RESOLUTION COLONIC MANOMETRY

2018 ◽  
Vol 1 (suppl_2) ◽  
pp. 415-416
Author(s):  
J Chen ◽  
M Shokrollahi ◽  
E Ratcliffe ◽  
D Armstrong ◽  
S P Parsons ◽  
...  
Keyword(s):  
High Resolution ◽  
Anal Sphincter ◽  
Colonic Manometry

Labyrinthitis ossificans: How accurate is MRI in predicting cochlear obstruction?

2009 ◽  
Vol 140 (5) ◽  
pp. 692-696 ◽  
Author(s):  
Brandon Isaacson ◽  
Timothy Booth ◽  
Joe W. Kutz ◽  
Kenneth H. Lee ◽  
Peter S. Roland
Keyword(s):  
High Resolution ◽  
Bacterial Meningitis ◽  
Cochlear Implant ◽  
Tertiary Care ◽  
Fibrous Tissue ◽  
Case Series ◽  
Prior History ◽  
Basal Turn ◽  
Labyrinthitis Ossificans ◽  
History Of

Objective: To determine the accuracy of preoperative MRI in predicting cochlear obstruction in pediatric patients with a history of bacterial meningitis. Methods: A case series with chart review was performed at a tertiary care multidisciplinary cochlear implant program. Forty-five children with hearing loss that resulted from bacterial meningitis were implanted from 1991 to 2006. Twenty-five children had preoperative MRI with high-resolution axial T2-weighted images to assess for cochlear patency. Results: Seventeen of 25 patients (68%) had surgical evidence of cochlear obstruction. Six patients (37.5%) required circummodiolar drill-outs, and one patient (6.25%) underwent placement of a double array cochlear implant. The nine remaining patients (56%) with cochlear obstruction required removal of fibrous tissue or drilling of the inferior basal turn, but did not require manipulation of the ascending basal turn to achieve full electrode insertion. The sensitivity, specificity, and positive and negative predictive value of MRI predicting intraoperative cochlear obstruction with 95 percent confidence intervals was 94.1 percent (71–99), 87.5 percent (47–99), 94.1 percent (71–99) and 87.5 percent (47–99), respectively. Conclusion: Preoperative high-resolution T2 MRI may be useful in predicting cochlear obstruction in patients with a prior history of bacterial meningitis.

837 The Spatiotemporal Characteristics of Retrograde Motor Activity in the Distal Colon Defined by High-Resolution Colonic Manometry

2016 ◽  
Vol 150 (4) ◽  
pp. S177 ◽  
Author(s):  
Anthony Y. Lin ◽  
Peng Du ◽  
Jozef Kamp ◽  
Leo K. Cheng ◽  
Philip Dinning ◽  
...  
Keyword(s):  
High Resolution ◽  
Motor Activity ◽  
Distal Colon ◽  
Spatiotemporal Characteristics ◽  
Colonic Manometry

S162 – Chronic Aspiration after Supracricoid Partial Laryngectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P130-P131
Author(s):  
Andrea Gallo ◽  
Giovanni Ruoppolo ◽  
Marco Di Mario ◽  
Calcagno Paola ◽  
Manciocco Valentina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Case Series ◽  
Control Group ◽  
Chronic Obstructive ◽  
Partial Laryngectomy ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Supracricoid Partial Laryngectomy ◽  
Control Evaluation

Objectives The aim of this study is to evaluate the long-term swallowing status and the high resolution computed tomography (HRCT) pulmonary findings of chronic aspiration in patients who have undergone supracricoid partial laryngectomy (SCPL), to demonstrate that SCPL causes a mild and well-tolerated degree of chronic aspiration, allowing the patient to avoid a nothing-by-mouth status. Methods Retrospective medical record review. Cohort study. Case series. The follow-up period ranged from 3 to 13 years. 116 patients treated with SCPL were analyzed. The patients included in the study were NED, were followed for more than 3 years, were without tracheal cannula or nasogastric tube, and able to feed orally. A group of 20 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control. Evaluation of postoperative swallowing disorders included a careful observation of the patients by the physician, fiberoptic endoscopic evaluation of swallowing (FEES), and videofluoroscopy (VFS). Clinical grading of postoperative aspiration was assessed according to the Leipzig and Pearson scale. The radiological manifestations of chronic aspiration were recorded at high resolution computed tomography (HRCT). Results A higher incidence of pulmonary consolidation was found in the patients affected by postoperative chronic aspiration, compared to the control group (p<0.001). No significant differences were noted between the control group and the dysphagic group regarding the remaining radiological findings. Conclusions SCPL causes a mild and well-tolerated degree of chronic aspiration, determining low functional impairment and allows the patient a good quality of life.

scholarly journals High-resolution manometry in the diagnosis and classification of achalasia in children

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Erick Toro-Monjaraz ◽  
Rubén Peña-Vélez ◽  
María José Carrillo-Quan ◽  
David Avelar-Rodríguez ◽  
Martha Cecilia Martínez-Soto ◽  
...  
Keyword(s):  
High Resolution ◽  
Pediatric Patients ◽  
Case Series ◽  
Esophageal Achalasia ◽  
Motor Disorder ◽  
High Resolution Manometry ◽  
Chicago Classification ◽  
Diagnosis And Classification ◽  
Esophageal Sphincter

Esophageal achalasia is a primary motor disorder that presents with dysphagia secondary to esophageal body dysfunction and functional obstruction of the lower esophageal sphincter. High-resolution manometry is considered the gold standard for the diagnosis of achalasia and, according to the Chicago classification v3.0; it can be further divided into three different subtypes based on the pressurization patterns. Herein, we present the case series of 6 pediatric patients in whom high-resolution manometry was performed for the diagnosis and classification of esophageal achalasia.

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