J Gastroenterol Hepatol Endosc | Volume 2, Issue 6 | Research Article | Open Access
Shamaila Waseem1*, Fatima W Jafri1, Esther D Kisseih2, Erum Rizvi BS3, William E Bennett Jr1 and Joseph Croffie1
1Department of Pediatric Gastroenterology/Hepatology/Nutrition Section, Indiana University School of Medicine/ Riley Hospital for Children at IU Health, Indianapolis, USA
2Department of Pediatric Gastroenterology, Children’s Hospital of Michigan/Wayne State University, Detroit, USA
3Department of Pediatric Gastroenterology, Indiana University/Purdue University, Indianapolis, USA
*Correspondance to: Shamaila Waseem
Fulltext PDFObjectives: Once anatomical causes are ruled-out, esophageal manometry is the test of choice for diagnosis for esophageal dysmotilities in children. There are currently two types: water-perfused conventional manometry (conventional EM) and high-resolution esophageal manometry (HREM). HREM has been introduced recently and has become the standard of care. There is scarcity of information on pediatric esophageal dysmotilities and therefore, the aim of our study was to observe and describe the etiologies of these disorders in children at our center over a period of 12 years.
Methods: We retrospectively reviewed medical records of a cohort of patients who underwent esophageal manometry studies from January 2001 to June 2013. We recorded age, gender, year of study, indication and results.
Results: A total of 94 subjects were selected for our study. The median age of children in our study was 13 years. In our cohort, the most common indication for manometry was dysphagia (80%). We found that 38% of our subjects had normal motility. The most frequently diagnosed conditions were achalasia (22%) and ineffective esophageal motility disorder/minor peristaltic abnormalities (HREM) (22%). Other diagnoses included hypotensive LES, found in 8%, esophageal spasms found in 4%, and hypertensive LES/EGJ outflow obstruction (HREM) which was found in 4% of subjects. Two percent of our subjects had scleroderma, while 0% was found to have hypertensive peristalsis of the esophagus (Nutcracker esophagus/Jackhammer esophagus).
Conclusion: As in adult studies, our observation in children revealed that achalasia and ineffective esophageal motility disorder/minor peristaltic abnormalities (HREM) accounted for most of the motility disorders that were detected. Further studies will be useful to investigate the characteristics of patients diagnosed with these disorders.
Dysmotilities; Dysphagia; Esophageal manometry; Achalasia
Waseem S, Jafri FW, Kisseih ED, Erum Rizvi BS, Bennett Jr WE, Croffie J. A 12 Year Experience with Conventional and High Resolution Esophageal Manometry in Children. J Gastroenterol Hepatol Endosc. 2017;2(6):1033.