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Monitoring the lower oesophageal sphincter: sphinctometer or sleeve?
Author(s) -
Nigel Trudgill,
S Riley
Publication year - 1999
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1046/j.1365-2982.1999.00151.x
Subject(s) - reflux , asymptomatic , interquartile range , medicine , gastroenterology , esophageal sphincter , gerd , cardiology , urology , disease
Two methods have been used to study lower oesophageal sphincter (LOS) function in gastro‐oesophageal reflux disease: the sleeve sensor and the sphinctometer. Our aim was to directly compare the sleeve and sphinctometer in vivo. Ten asymptomatic volunteers were intubated with a perfused assembly incorporating a sleeve sensor, a solid‐state assembly incorporating a sphinctometer and a pH probe. LOS function was recorded pre‐ and post‐prandially. During basal periods sleeve and sphinctometer readings correlated well both within and between subjects (r 2 = 0.89 (P < 0.0001)). However, the sphinctometer relaxed less during swallows (median 42 (interquartile range 27–55)% vs 73 (62–81)% (P < 0.001)), transient LOS relaxations (TLOSR) (50 (40–70)% vs 94 (88–100)% (P < 0.001)) and reflux episodes (67 (59–75)% vs 97 (91–100)% (P = 0.02)). Using criteria derived from 10 dry swallows, the expected relaxation of the sphinctometer during TLOSR was defined. The sphinctometer had an overall sensitivity ranging from 43 to 71% for the detection of TLOSR with 11–22 false positive relaxations, depending on the criteria employed. Sensitivity was particularly poor in those with low basal LOS pressure. The sphinctometer has a lower capacity to register LOS relaxations than the sleeve sensor, which limits its value in studying the pathophysiology of reflux disease.