Displaying publications 1 - 20 of 26 in total

  1. Shanmuganathan G, Ritz MA, Holloway RH, Di Matteo AC, Omari TI
    J Gastroenterol Hepatol, 2000 Dec;15(12):1362-9.
    PMID: 11197044
    BACKGROUND AND AIMS: Perfused miniature manometric assemblies with lumina of 0.4-0.5 mm i.d. have been developed. Reduced luminal size offers the advantages of reduced assembly bulk and increased assembly complexity with greater numbers of lumina and lower manometric infusion volumes because of a slower perfusion rate. This study investigated the recording fidelity of miniature manometric assemblies in the measurement of esophageal peristalsis.

    METHODS: Four miniature manometric assemblies, each containing manometric lumina of either 0.4 or 0.5 mm i.d., were evaluated at 100 and 180 cm lengths. The fidelity of miniature manometric luminal recordings were evaluated in vivo during esophageal peristalsis by using a simultaneous comparison with the standard lumina and an intraluminal strain gauge.

    RESULTS: During esophageal peristalsis, miniature manometric lumina recorded the peak amplitude of pressure waves, with an accuracy at perfusion rates of 0.04 mL/min (0.4 mm, i.d.) and 0.15 mL/min (0.5 mm, i.d.).

    CONCLUSION: Miniature manometric assemblies of lengths that are practical for use in humans are suitable for recording esophageal peristalsis.

    Matched MeSH terms: Manometry/methods*; Manometry/standards*
  2. Chuah KH, Ramasami N, Mahendran HA, Shanmuganathan G, Koleth GG, Voon K, et al.
    J Gastroenterol Hepatol, 2024 Mar;39(3):431-445.
    PMID: 38087846 DOI: 10.1111/jgh.16403
    Disorders of esophagogastric junction (EGJ) outflow, including achalasia and EGJ outflow obstruction, are motility disorders characterized by inadequate relaxation of lower esophageal sphincter with or without impaired esophageal peristalsis. Current guidelines are technical and less practical in the Asia-Pacific region, and there are still massive challenges in timely diagnosis and managing these disorders effectively. Therefore, a Malaysian joint societies' task force has developed a consensus on disorders of EGJ outflow based on the latest evidence, while taking into consideration the practical relevance of local and regional context and resources. Twenty-one statements were established after a series of meetings and extensive review of literatures. The Delphi method was used in the consensus voting process. This consensus focuses on the definition, diagnostic investigations, the aims of treatment outcome, non-surgical or surgical treatment options, management of treatment failure or relapse, and the management of complications. This consensus advocates the use of high-resolution esophageal manometry for diagnosis of disorders of EGJ outflow. Myotomy, via either endoscopy or laparoscopy, is the preferred treatment option, while pneumatic dilatation can serve as a secondary option. Evaluation and management of complications including post-procedural reflux and cancer surveillance are recommended.
    Matched MeSH terms: Manometry/methods
  3. Lee YY, Erdogan A, Rao SS
    J Neurogastroenterol Motil, 2014 Oct 30;20(4):547-52.
    PMID: 25230902 DOI: 10.5056/jnm14056
    Management of chronic constipation with refractory symptoms can be challenging. Although new drugs and behavioral treat-ments have improved outcome, when they fail, there is little guidance on what to do next. At this juncture, typically most doc-tors may refer for surgical intervention although total colectomy is associated with morbidity including complications such as recurrent bacterial overgrowth. Recently, colonic manometry with sensory/tone/compliance assessment with a barostat study has been shown to be useful. Technical challenges aside, adequate preparation, and appropriate equipment and knowledge of co-lonic physiology are keys for a successful procedure. The test itself appears to be safe with little complications. Currently, colon-ic manometry is usually performed with a 6-8 solid state or water-perfused sensor probe, although high-resolution fiber-optic colonic manometry with better spatiotemporal resolutions may become available in the near future. For a test that has evolved over 3 decades, normal physiology and abnormal findings for common phenotypes of chronic constipation, especially slow transit constipation, have been well characterized only recently largely through the advent of prolonged 24-hour ambulatory colonic manometry studies. Even though the test has been largely restricted to specialized laboratories at the moment, emerg-ing new technologies and indications may facilitate its wider use in the near future.(J Neurogastroenterol Motil 2014;20:547-552).
    Matched MeSH terms: Manometry
  4. Lee YY, Erdogan A, Yu S, Dewitt A, Rao SSC
    J Neurogastroenterol Motil, 2018 Jul 30;24(3):460-468.
    PMID: 29879762 DOI: 10.5056/jnm17081
    Background/Aims: Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known.

    Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated.

    Results: Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed.

    Conclusions: Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.

    Matched MeSH terms: Manometry
  5. Chaharborj SS, Amin N
    PLoS One, 2020;15(2):e0228955.
    PMID: 32106248 DOI: 10.1371/journal.pone.0228955
    This paper discusses the optimal control of pressure using the zero-gradient control (ZGC) approach. It is applied for the first time in the study to control the optimal pressure of hydrogen natural gas mixture in an inclined pipeline. The solution to the flow problem is first validated with existing results using the Taylor series approximation, regression analysis and the Runge-Kutta method combined. The optimal pressure is then determined using ZGC where the optimal set points are calculated without having to solve the non-linear system of equations associated with the standard optimization problem. It is shown that the mass ratio is the more effective parameter compared to the initial pressure in controlling the maximum variation of pressure in a gas pipeline.
    Matched MeSH terms: Manometry/methods
  6. Tan WS, Md Hasan Z, Sanmugam A, Singaravel S, Abdullah MY, Nah SA
    J Pediatr Surg, 2023 Feb;58(2):241-245.
    PMID: 36384936 DOI: 10.1016/j.jpedsurg.2022.10.031
    INTRODUCTION: Anorectal manometry may be useful to objectively evaluate anorectal function following definitive pullthrough for Hirschsprung Disease (HD) but there is little published data. Our study aims to investigate anorectal manometry findings and their association with bowel function.

    METHODOLOGY: This was a prospective observational study. Convenience sampling method was used to recruit all HD patients who had definitive pullthrough from January 2019 to December2020 in our institution. High-resolution anorectal manometry (HRAM) was used to record anal resting pressure (ARP), length of high-pressure zone (HPZ), and presence/absence of recto-anal inhibitory reflex (RAIR). The Paediatric Incontinence/Constipation Scoring System (PICSS) was scored for all participants. PICSS is a validated questionnaire with scores mapped to an age-specific normogram to denote constipation, incontinence, and their combinations. Non-parametric and chi-square tests at significance p<0.05 were conducted to examine the relationship between PICSS categories and manometry findings. Ethical approval was obtained.

    RESULTS: There were 32 participants (30 boys). Median age at participation was 26.5 months (range: 13.8-156). Twenty-four (75%) had transanal pullthrough, 8(25%) underwent Duhamel procedure. PICSS scored 10(31.3%) as normal, 8(25%) as constipation, 10(31.3%) as incontinent, and 4(12.5%) as mixed. RAIR was present in 12 patients (37.5%). HPZ, maximum ARP, mean ARP were comparable across all PICSS groups without statistically significant differences. Presence of RAIR was not significantly associated with any PICSS groups (p = 0.13).

    CONCLUSION: Bowel function does not appear to be significantly associated with HRAM findings after definitive pullthrough for HD, but our study is limited by small sample size. RAIR was present in 37.5% patients after pullthrough.


    Matched MeSH terms: Manometry/methods
  7. Siboni S, Kristo I, Rogers BD, De Bortoli N, Hobson A, Louie B, et al.
    Clin Gastroenterol Hepatol, 2023 Jul;21(7):1761-1770.e1.
    PMID: 36270615 DOI: 10.1016/j.cgh.2022.10.008
    BACKGROUND & AIMS: The straight leg raise (SLR) maneuver during high-resolution manometry (HRM) can assess esophagogastric junction (EGJ) barrier function by measuring changes in intraesophageal pressure (IEP) when intra-abdominal pressure is increased. We aimed to determine whether increased esophageal pressure during SLR predicts pathologic esophageal acid exposure time (AET).

    METHODS: Adult patients with persistent gastroesophageal reflux disease (GERD) symptoms undergoing HRM and pH-impedance or wireless pH study off proton pump inhibitor were prospectively studied between July 2021 and March 2022. After the HRM Chicago 4.0 protocol, patients were requested to elevate 1 leg at 45º for 5 seconds while supine. The SLR maneuver was considered effective when intra-abdominal pressure increased by 50%. IEPs were recorded 5 cm above the lower esophageal sphincter at baseline and during SLR. GERD was defined as AET greater than 6%.

    RESULTS: The SLR was effective in 295 patients (81%), 115 (39%) of whom had an AET greater than 6%. Hiatal hernia (EGJ type 2 or 3) was seen in 135 (46%) patients. Compared with patients with an AET less than 6%, peak IEP during SLR was significantly higher in the GERD group (29.7 vs 13.9 mm Hg; P < .001). Using receiver operating characteristic analysis, an increase of 11 mm Hg of peak IEP from baseline during SLR was the optimal cut-off value to predict an AET greater than 6% (area under the receiver operating characteristic curve, 0.84; sensitivity, 79%; and specificity, 85%), regardless of the presence of hiatal hernia. On multivariable analysis, an IEP pressure increase during the SLR maneuver, EGJ contractile integral, EGJ subtype 2, and EGJ subtype 3, were found to be significant predictors of AET greater than 6% CONCLUSIONS: The SLR maneuver can predict abnormal an AET, thereby increasing the diagnostic value of HRM when GERD is suspected.

    CLINICALTRIALS: gov ID: NCT04813029.

    Matched MeSH terms: Manometry/methods
  8. Che Hamzah J, Daka Q, Azuara-Blanco A
    Eye (Lond), 2020 01;34(1):155-160.
    PMID: 31772381 DOI: 10.1038/s41433-019-0669-7
    Glaucoma services are overwhelmed and struggling to accommodate current demand. Reducing the need for hospital based services would improve our ability to see those most at risk of vision loss, which could both reduce demand and improve patient outcomes. Digital technologies that provide opportunities for home monitoring of glaucoma progression have potential to contribute to solve these challenges and, potentially, improve glaucoma care. This article will review the literatures of well-established technologies that support home monitoring for glaucoma, specifically home tonometry (with rebound tonometry) and perimetry with Moorfields Motion Displacement Test and Melbourne Rapid Field.
    Matched MeSH terms: Manometry
  9. Lazarescu A, Chan WW, Gyawali CP, Lee YY, Xiao Y, Wu P
    Ann N Y Acad Sci, 2020 12;1481(1):108-116.
    PMID: 32875574 DOI: 10.1111/nyas.14453
    Esophageal dysphagia is a common symptom in adults. Fluoroscopic contrast studies, endoscopy, and esophageal manometry have been used in the diagnosis of esophageal dysphagia for many years. The diagnostic yield has been improved with new test protocols that highlight abnormal bolus transit in the esophagus and outflow obstruction, as well as new high-definition and high-resolution technical advances in equipment. Functional luminal impedance planimetry and the addition of impedance to high-resolution esophageal manometry have also allowed the assessment of new parameters to better understand esophageal structure and function. In this concise review, we describe the role and utility of various diagnostic modalities in the assessment of patients with esophageal dysphagia.
    Matched MeSH terms: Manometry
  10. Ata-Lawenko RM, Lee YY
    J Neurogastroenterol Motil, 2017 Apr 30;23(2):164-170.
    PMID: 28013295 DOI: 10.5056/jnm16171
    Gastrointestinal sphincters play a vital role in gut function and motility by separating the gut into functional segments. Traditionally, function of sphincters including the esophagogastric junction is studied using endoscopy and manometry. However, due to its dynamic biomechanical properties, data on distensibility and compliance may provide a more accurate representation of the sphincter function. The endolumenal functional lumen imaging probe (EndoFLIP) system uses a multi-detector impedance planimetry system to provide data on tissue distensibility and geometric changes in the sphincter as measured through resistance to volumetric distention with real-time images. With the advent of EndoFLIP studies, esophagogastric junction dysfunction and other disorders of the stomach and bowels may be better evaluated. It may be utilized as a tool in predicting effectiveness of endoscopic and surgical treatments as well as patient outcomes.
    Matched MeSH terms: Manometry
  11. Rogers BD, Rengarajan A, Abrahao L, Bhatia S, Bor S, Carlson DA, et al.
    Neurogastroenterol Motil, 2021 06;33(6):e14009.
    PMID: 33094875 DOI: 10.1111/nmo.14009
    BACKGROUND: Esophagogastric junction contractile integral (EGJ-CI) and EGJ morphology are high-resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited.

    METHODS: Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ-CI was calculated by the same two investigators using a distal contractile integral-like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg cm), using manufacturer-specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ-CI values were calculated across age, genders, HRM systems, and regions.

    RESULTS: Of 484 studies (28.0 years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ-CI was similar between Medtronic (37.0 mm Hg cm, IQR 23.6-53.7 mm Hg cm) and Diversatek (34.9 mm Hg cm, IQR 22.1-56.1 mm Hg cm, P = 0.87), but was significantly higher using Laborie equipment (56.5 mm Hg cm, IQR 35.0-75.3 mm Hg cm, P 

    Matched MeSH terms: Manometry/instrumentation; Manometry/methods*
  12. Yulia DE, Tan S
    Med J Malaysia, 2024 Mar;79(2):206-211.
    PMID: 38553928
    INTRODUCTION: Numerous tonometers are available to measure intraocular pressure (IOP) in children with glaucoma. This review aims to discuss IOP measurement techniques and principles and compare the accuracy, tolerability and ease of use of available tonometers in measuring IOP in paediatric glaucoma patients.

    MATERIALS AND METHODS: A review of observational studies was conducted to discuss the accuracy, tolerability and ease of use of tonometers in measuring IOP in children with glaucoma.

    RESULTS: Goldmann applanation tonometry (GAT) and its portable handheld versions remain the gold standard in measuring IOP. Tono-Pen (Reichert Ophthalmic Instruments, Depew, New York, USA) and rebound tonometer (RBT) both correlate well with GAT. Although both tonometers tend to overestimate IOP, Tono-Pen overestimates more than RBT. Overestimation is more remarkable in higher IOP and corneal pathologies (such as but not limited to scarred cornea and denser corneal opacity). RBT was better tolerated than other tonometers in children and was easier to use in children of all ages.

    CONCLUSIONS: RBT is the preferred tonometer for measuring IOP in children with glaucoma, as it is less traumatic, time efficient and does not require fluorescein dye or anaesthesia. However, examiners should use a second tonometer to confirm elevated IOP readings from the RBT.

    Matched MeSH terms: Manometry
  13. Mohd Said MR, Wong Z, Abdul Rani R, Ngiu CS, Raja Ali RA, Lee YY
    J Gastroenterol Hepatol, 2021 May;36(5):1244-1252.
    PMID: 33002243 DOI: 10.1111/jgh.15284
    BACKGROUND AND AIM: Variations in the Chicago 3.0 normative metrics may exist with different postures and with different provocative swallow materials in a healthy Asian population.

    METHOD: Eligible healthy Malay volunteers were invited to undergo the high-resolution esophageal manometry (inSIGHT Ultima, Diversatek Healthcare, Milwaukee, WI, USA). In recumbent and standing positions, test swallows were performed using liquid, viscous, and solid materials. Metrics including integrated relaxation pressure 4 s (IRP-4 s, mmHg), distal contractile integral (DCI, mmHg s cm), distal latency (DL, s), and peristaltic break (PB, cm) were reported in median and 95th percentile.

    RESULTS: Fifty of 57 screened participants were recruited, and 586 saline, 265 viscous, and 261 solid swallows were analyzed. Per-patient wise, in the recumbent position, 95th percentile for IRP-4 s, DCI, DL, and PB were 16.5 mmHg, 2431 mmHg s cm, 8.5 s, and 7.2 cm, respectively. We observed that with each posture, the use of viscous swallows led to changes in DL, but the use of solid swallows led to more changes in the metrics including DCI and length of PB. Compared with a recumbent posture, anupright posture led to lower IRP-4 s and DCI values. Both per-patient analysis and per-swallow analyses yielded almost similar results when comparing the different postures and types of swallows. No major motility disorders were observed in this cohort of asymptomatic population. However, more motility disorders were reported in the upright position.

    CONCLUSIONS: Variations in metrics can be observed in different postures and with different provocative swallow materials in a healthy population. The normative Chicago 3.0 metrics are also determined for the Malay population.

    Matched MeSH terms: Manometry/methods*
  14. Boo HS, Chik I, Ngiu CS, Lim SY, Jarmin R
    Am J Case Rep, 2018 Aug 23;19:998-1003.
    PMID: 30135416 DOI: 10.12659/AJCR.909717
    BACKGROUND The esophagus can be affected by a variety of disorders that may be primary or secondary to another pathologic process, but the resulting symptoms are usually not pathognomonic for a specific problem, making diagnosis and further management somewhat challenging. High resolution impedance manometry (HRiM) has established itself as a valuable tool in evaluating esophageal motility disorder. HRiM is superior in comparison with conventional water perfused manometric recordings in delineating and tracking the movement of functionally defined contractile elements of the esophagus and its sphincters, and in distinguishing the luminal pressurization of spastic esophageal contraction from a trapped bolus. Making these distinctions can help to identify achalasia, distal esophageal spasm, functional obstruction, and subtypes according to the latest Chicago Classification of Esophageal Motility Disorders version 3.0. CASE REPORT We report a case series of 4 patients that presented with dysphagia; and with the ancillary help of the HRiM, we are able to diagnose esophageal motility disorder and evaluate its pathogenetic mechanism. This approach aids in tailoring each management individually and avoiding disastrous mismanagement. CONCLUSIONS From the series of case reports, we believe that HRiM has an important role to play in deciding appropriate management for patients presenting with esophageal motility disorders, and HRiM should be performed before deciding on management.
    Matched MeSH terms: Manometry/methods*
  15. Mori H, Schol J, Geeraerts A, Huang IH, Jandee S, Gonlachanvit S, et al.
    J Clin Med, 2020 Oct 01;9(10).
    PMID: 33019626 DOI: 10.3390/jcm9103189
    BACKGROUND: The new coronavirus disease (COVID-19) has high infection and mortality rates, and has become a pandemic. The infection and mortality rates are lower in Asian countries than in European countries. This study aimed to conduct a survey on the effects of COVID-19 on the capacity to perform gastrointestinal motility tests in Asian countries compared with European countries.

    METHODS: We used the questionnaire previously established by our team for researchers in European countries. The correlation between the decreased rate of gastrointestinal motility and function tests, and the infection/mortality rates of COVID-19 and stringency of a government's interventions in each country was analysed and protective measures were assessed.

    RESULTS: In total, 58 gastroenterologists/motility experts in Asian countries responded to this survey. The infection/mortality rates of COVID-19 and Stringency Index had a significant impact on the testing capacity of oesophageal manometry and catheter-based pH monitoring. In European countries, most facilities used filtering facepiece 2/3 (FFP2/3) masks during oesophageal motility studies. Meanwhile, in Asian countries, most facilities used surgical masks.

    CONCLUSION: The total infection and mortality rates of COVID-19 can affect the rate of gastrointestinal motility testing and the type of protective equipment that must be used.

    Matched MeSH terms: Manometry
  16. Marina, M.B., Mohd Tahir, J., Mawaddah, A., Asma, A., Mohd Razif, M.Y., Jemaima, C.H.
    Medicine & Health, 2018;13(2):36-47.
    Obstructive Sleep Apnoea (OSA) affects 2-5% of the middle-aged population and is a potentially life-threatening condition. Previous studies on OSA and glaucoma have reported mixed findings. This was a cross-sectional comparative study with a study duration of one year to compare the incidence of high intraocular pressure among OSA subjects and non-OSA subjects. This study took place in a tertiary hospital where a total of 50 subjects with OSA and 50 non-OSA subjects were recruited. The average age was 37 years (19,65) in a multiethnic study population (76% (Malay), 18% (Chinese) and 6% (Indian)). All patients underwent a full night computer-assisted polysomnogram (SOMNOCheck Effort Weinmann, Hamburg, Germany), Epworth Sleepiness Scale (ESS), Mullers manouevre (MM) to assess the level of obstruction and tonometry. The incidence of high Intra Ocular Pressure (IOP) among OSA subject was 52% with a significant difference between non-OSA and OSA subjects. Correlation between ESS and IOP were significant (p
    Matched MeSH terms: Manometry
  17. Linsay Sundram Gnanasundram, Bashirah Ishak, Aloysius Joseph Low, Rokiah Omar
    This study reports the vision status of a presbyopic patient who has undergone a corneal inlay procedure. The study
    hopes to provide optometrists more insight on the procedure and the co-management involved in such a patient. The
    patient, a 48 years-old Chinese woman with presbyopia underwent the corneal inlay procedure three years ago.
    She had the inlay implanted in the non-dominant eye to aid near vision i.e. her left eye. The pre and post-operative
    evaluations include distance and near visual acuity, fundoscopy, tonometry, Schirmer’s test, slit lamp evaluation, corneal
    topography and corneal pachymetry. Near visual acuity for the left eye improved from N14 to N5 immediately after
    the procedure. Even after 3 years of post-operative followup, the patient was still able to maintain her near vision. In
    conclusion, the corneal inlay procedure helped to improve near vision of this presbyopic patient. Optometrist plays
    a very important role in the co-management of such patients alongside with the ophthalmologist in terms of visual
    functional assessments pre and post-surgery, counseling of the procedure and managing patients’ expectations.
    Matched MeSH terms: Manometry
  18. Chuah SK, Lim CS, Liang CM, Lu HI, Wu KL, Changchien CS, et al.
    Biomed Res Int, 2019;2019:8549187.
    PMID: 30881999 DOI: 10.1155/2019/8549187
    Over the past few decades, there was an encouraging breakthrough in bridging the gap between advancements in the evolution of diagnosis and treatment towards a better outcome in achalasia. The purpose of this review is to provide updated knowledge on how the current evidence has bridged the gap between advancements in the evolution of diagnosis and treatment of esophageal achalasia. The advent of high-resolution manometry and standardization based on the Chicago classification has increased early recognition of the disease. These 3 clinical subtypes of achalasia can predict the outcomes of patients, and the introduction of POEM has revolutionized the choice of treatment. Previous evidence has shown that laparoscopic Heller myotomy (LHM) and anterior fundoplication were considered the most durable treatments for achalasia. Based on the current evidence, POEM has been evolving as a promising strategy and is effective against all 3 types of achalasia, but the efficacy of POEM is based on short- and medium-term outcome studies from a limited number of centers. Types I and II achalasia respond well to POEM, LHM, and PD, while most studies have shown that type III achalasia responds better to POEM than to LHM and PD. In general, among the 3 subtypes of achalasia, type II achalasia has the most favorable outcomes after medical or surgical therapies. The long-term efficacy of POEM is still unknown. The novel ENDOFLIP measures the changes in intraoperative esophagogastric junction dispensability, which enables a quantitative assessment of luminal patency and sphincter distension; however, this technology is in its infancy with little data to date supporting its intraoperative use. In the future, identifying immunomodulatory drugs and the advent of stem cell therapeutic treatments, including theoretically transplanting neuronal stem cells, may achieve a functional cure. In summary, it is important to identify the clinical subtype of achalasia to initiate target therapy for these patients.
    Matched MeSH terms: Manometry
  19. Suresh RL, Kulhalli V, Evans D, Guinane M, Ainley C
    Med J Malaysia, 2000 Sep;55(3):379-81.
    PMID: 11200722
    We report 2 cases where treatment of achalasia type symptoms due to severe non-specific oesophageal dysmotility have shown symptom resolution and manometric improvement to intrasphincteric botulinum injections either by itself or in combination with oesophageal dilatation.
    Matched MeSH terms: Manometry
  20. Nawawi KNM, Wong Z, Ngiu CS, Raja Ali RA
    Med J Malaysia, 2019 12;74(6):540-542.
    PMID: 31929483
    Distal oesophageal spasm is a rare condition that affects the motility of the oesophagus. It can be diagnosed by highresolution oesophageal manometry and the diagnosis is supported by other modalities such as barium swallow and esophagogastroduodenoscopy examinations. Treatment options include pharmacological therapy, endoscopy and surgical interventions. We described a case of distal oesophageal spasm in an elderly patient who presented with chronic dyspepsia.
    Matched MeSH terms: Manometry
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