Provision of facilities for manometry and pH monitoring in the investigation of patients with oesophageal disease

Article Abstract:

Esophageal manometry is a diagnostic technique in which pressure sensors in the esophagus analyze the force and rate of contractions of the esophageal musculature, as well as the dynamics of peristalsis (the descending wave of sequential contraction and relaxation of the esophagus that occurs during swallowing). Ambulatory pH monitoring is a method for measuring the acidity (pH) of the esophagus (and occasionally the stomach) in patients while they are performing their normal daily routine (with no need for hospitalization). Both of these diagnostic tools are critical for the identification of many gastrointestinal diseases, as well as for evaluating the success of therapeutic interventions. Recent surveys have indicated that only a small percentage of physicians routinely perform esophageal manometry or ambulatory pH monitoring in the treatment of patients with esophageal diseases. This is largely the result of the limited availability of facilities for performing such procedures. It is suggested that, given the importance of these tools in the management of esophageal disease, additional financial and manpower commitments should be made to increase the availability of these services. This will require allocating funds from either private or public sectors for the purchase and maintenance of the requisite equipment, as well as financing training and salaries for support personnel. It is recommended that there should be at least one facility capable of performing these procedures for every 400,000 residents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Medical examination, Esophagus, Hydrogen-ion concentration, pH measurement, Digestive system diseases, Manometer, Manometers

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Jejunal bacterial overgrowth and intestinal permeability in children with immunodeficiency syndromes

Article Abstract:

Immunodeficiency is a general term that encompasses a variety of disease states characterized by compromised immune system function. In spite of the wide variety of disease processes involved in immunodeficiency, many immunodeficient states present a similar clinical profile, primarily characterized by recurrent infections. Particularly in young patients, gastrointestinal disorders such as malabsorption and chronic diarrhea are frequently seen. These gastrointestinal disorders are often associated with bacterial or viral infection. In some cases, this may result in increased intestinal permeability, allowing dietary antigens (substances that stimulate antibody formation) to pass through the intestinal wall and enter the bloodstream. This may eventually increase the risk of autoimmune diseases and lymphoma. In order to investigate the degree of intestinal bacterial infection and intestinal permeability, a group of 17 pediatric patients (ages 2 to 17 years) with several different types of immunodeficiency was studied. Forty-two percent of the patients had intestinal (jejunal) bacterial infection, and this occurred equally in the various types of immunodeficiency. Ninety-four percent of the patients had increased intestinal permeability to large molecules. Eleven of the patients had gastrointestinal dysfunction. These results indicate that increased intestinal permeability, bacterial infection, and impaired gastrointestinal function are hallmarks of a variety of different immunodeficient states. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Infection, Complications and side effects, Pediatric diseases, Immunological deficiency syndromes, Immunologic deficiency syndromes, Immunologic diseases, Intestinal mucosa, Immunologic diseases in children

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Jejunal manometry in distal subacute mechanical obstruction: significance of prolonged simultaneous contractions

Article Abstract:

The value of jejunal manometry in the diagnosis of subacute mechanical obstruction of the small bowel was assessed. Readings taken by a manometer, an instrument which measures pressure or tension, of 850 patients with unexplained nausea, vomiting, abdominal pain or altered bowel movements were analyzed. Sixteen cases were identified with features suggesting a mechanical obstruction: prolonged simultaneous contractions and clustered contractions after a meal. Prolonged simultaneous contractions suggest bowel obstruction. Clustered contractions lasting over 30 minutes are less definitive, whereas clustered contractions lasting less than 20 minutes are not associated with obstruction.

Intestines, Muscle contraction, Gastrointestinal system, Gastrointestinal motility, Intestinal obstruction

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