Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure.

Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. Research Abstract Details 

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Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. Abstract Text:

J C Myers,G G Jamieson,

Purpose Distal oesophageal ramp pressure upon swallowing results from resistance from the oesophago-gastric junction below and pressure from above (peristaltic wave) with pressure build-up in the distal oesophagus. Ramps are observed during manometry, but the factors which influence the magnitude of ramp pressure have not been elucidated. This study aims to establish the normal range for ramp pressures and ascertain manometric and anatomic features which affect ramp pressure, in order to study ramp pressures and dysphagia following antireflux surgery. Methodology A standard 8 channel motility catheter with a sleeve was used with a water perfused manometry system, to record the ramps at 3 cm above the lower oesophageal sphincter (LOS) associated with ten 5 mL water swallows. Results 614 water swallows (5 mL) have been analysed in 68 subjects: 20 controls, 25 reflux patients and 23 patients after a partial (12) or total (11) fundoplication. Control patients had LOS of 17 +/- 0.4 mmHg, relaxation pressure of 1.4 +/- 0.2 mmHg and a ramp of 8 +/- 0.3 mmHg (mean +/- std error). Reflux patients had significantly lower pressures than controls for all parameters studied. As expected after anti-reflux surgery, all pressures were significantly higher with total fundoplication producing the highest pressures. The ramp pressure after total fundoplication was 22 +/- 0.6 mmHg and after partial fundoplication was 15 +/- 0.5 mmHg. Conclusions Ramp pressure integrates the distal peristaltic amplitude with lower oesophageal resistance to outflow. It is possible that lower rates of dysphagia after partial fundoplication are associated with lower ramp pressures. However the relationship between ramp pressure and dysphagia remains to be elucidated.

Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. Publishing Authors By Initials

JC Myers,GG Jamieson,

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Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: ANZ journal of surgery

VOLUME: 77 Suppl 1

Page Numbers: A43

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ISSN: 1445-1433

DAY: 10

MONTH: May

YEAR: 2007

Hp14 determining the manometric and anatomic features which influence distal oesophageal ramp pressure. Information

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LANGUAGE: eng

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AFFILIATION: University of Adelaide, South Australia, Australia.

Country: Australia

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MEDLINETA: ANZ J Surg

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