Evaluation of the pylorus with concurrent intraluminal pressure and EndoFLIP in patients with nausea and vomiting

Background Nausea and vomiting occurs in gastroparesis due to diabetes mellitus or unknown causes. The aim of this study was to compare (i) pyloric distensibility to pyloric manometric pressure in patients with nausea and vomiting and (ii) to correlate distensibility with delays in gastric emptying....

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Bibliographic Details
Published in:Neurogastroenterology and motility 2016-05, Vol.28 (5), p.758-764
Main Authors: Snape, W. J., Lin, M. S., Agarwal, N., Shaw, R. E.
Format: Article
Language:English
Subjects:
endoFLIP
Endoscopy, Gastrointestinal - methods
Female
gastric emptying
Gastric Emptying - physiology
gastroparesis
Gastroparesis - diagnosis
Gastroparesis - physiopathology
Humans
Male
Manometry - methods
Nausea - diagnosis
Nausea - physiopathology
Prospective Studies
pylorus
Pylorus - physiopathology
sleeve manometer
Vomiting - diagnosis
Vomiting - physiopathology
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Summary:Background Nausea and vomiting occurs in gastroparesis due to diabetes mellitus or unknown causes. The aim of this study was to compare (i) pyloric distensibility to pyloric manometric pressure in patients with nausea and vomiting and (ii) to correlate distensibility with delays in gastric emptying. Methods Sleeve manometry and EndoFLIP were performed sequentially during the same endoscopy on 114 patients with nausea and vomiting (47 with diabetes mellitus and 67 with idiopathic cause) after a standardized gastric emptying study. The sleeve manometer was positioned fluoroscopically, and the EndoFLIP was placed endoscopically. Manometric pressure using a water‐perfused catheter and distensibility using an EndoFLIP filled with 40 cc of saline were measured from the pylorus. Key Results The basal pyloric pressure was elevated (>10 mmHg) in 34 patients and was normal in 80 patients. The basal and peak pressures were similar in patient with normal and delayed gastric emptying (p > 0.05). There was a significant decrease in distensibility (8.0 ± 1.0 mm2/mmHg) in patients with gastric retention (>20% at 4 h) compared with patients (12.4 ± 1.4 mm2/mmHg) (p < 0.01) with normal gastric retention (20%, distensibility is significantly decreased. EndoFLIP is a useful tool for evaluating pyloric function.
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.12772