Original articleAlimentary tractNormal Values of Esophageal Distensibility and Distension-Induced Contractility Measured by Functional Luminal Imaging Probe Panometry
Section snippets
Subjects
Healthy, asymptomatic (ie, free of esophageal symptoms including dysphagia, heartburn, and chest pain), adult volunteers were enrolled. Potential subjects were excluded for a previous diagnosis of esophageal, autoimmune, or eating disorders. Additional exclusion criteria included use of antacids or proton pump inhibitors, body mass index greater than 30 kg/m2, or a history of tobacco use or alcohol abuse. The study protocol was approved by the Northwestern University Institutional Review Board.
Subjects
Twenty-two asymptomatic volunteers were evaluated, but 1 was excluded because of a technical limitation and another because of frequent retching during the endoscopy/FLIP that limited interpretation, thus 20 subjects, with a mean age of 30 years (range, 23–44 y), were included (14 [70%] were women). Endoscopic examinations were normal in all 20 subjects. Sedation dosages were an average of 9 mg (range, 7–10 mg) midazolam and 193 mcg (range, 150–200 mcg) fentanyl.
Distensibility of the Esophagogastric Junction
The median EGJ-DI was 5.8 mm2/mm
Discussion
This study described the esophageal response to volumetric distention in 20 asymptomatic normal subjects and generated normative data focused on EGJ distensibility, esophageal body distensibility, and the contractile response to sustained volumetric distention. Focusing on EGJ-DI as the primary metric of EGJ opening function, our results support a previously defined cut-off value for normal of 2.8 mm2/mm Hg because 100% of our asymptomatic normal subjects exceeded this threshold.1, 3, 6
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Conflicts of interest These authors disclose the following: Dustin A. Carlson, Zhiyue Lin, Peter J. Kahrilas, and John E. Pandolfino hold shared intellectual property rights and ownership surrounding functional luminal imaging probe panometry systems, methods, and apparatus with Medtronic, Inc; and John E. Pandolfino holds stock options in Crospon, Inc, has served as a consultant for Given Imaging, Sandhill Scientific, Medtronic, Torax, and Ironwood, has received grants from Given Imaging and Impleo, and has served as a speaker for Given Imaging, Sandhill Scientific, Takeda, Astra Zeneca, Medtronic, and Torax. The remaining authors disclose no conflicts.
Funding Supported by grant R01 DK079902 (J.E.P.) from the Public Health Service and grants from the Scleroderma Research Foundation (M.H.).