New developments in esophageal function testing and esophageal manifestations of connective tissue disorders,Annals of the New York Academy of Sciences

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New developments in esophageal function testing and esophageal manifestations of connective tissue disorders
Annals of the New York Academy of Sciences ( IF 4.1 ) Pub Date : 2020-07-05 , DOI: 10.1111/nyas.14424
Junichi Akiyama ₁ , Junko Sumida ₁ , Kenichiro Nakagawa ₂ , Atsushi Masamune ₂ , Navapan Issariyakulkarn ₃ , Tanisa Patcharatrakul _{3,

4} , Katerina Shetler ₅ , Shiko Kuribayashi ₆ , Toshio Uraoka ₆ , George Triadafilopoulos ₇

Affiliation

This work summarizes new and emerging metrics and tools in esophageal function testing and their potential clinical impact. Because the diagnostic sensitivity and reliability of conventional impedance‐pH variables are suboptimal, several novel impedance parameters, such as the postreflux swallow–induced peristaltic wave index and the mean nocturnal baseline impedance, as well as mucosal impedance, are entering a validation stage prior to general clinical use. The accurate diagnosis of behavioral disorders in patients with rumination syndrome and supragastric belching using ambulatory multiple intraluminal impedance‐pH can lead directly to behavioral interventions in patients with refractory gastroesophageal reflux disease (GERD). New provocative measures, such as multiple rapid swallows and the rapid drink challenge, have been developed to overcome the limitations of standard high‐resolution esophageal manometry, aiming at further clarifying esophageal dysmotility. Furthermore, the current diagnostic and therapeutic challenges in patients with esophageal involvement in Sjogren's syndrome and scleroderma, who tend to have severe forms of GERD, are entering a new investigative and clinical phase.

中文翻译：

结缔组织病食管功能检查及食管表现的新进展

这项工作总结了食管功能测试中新出现的指标和工具及其潜在的临床影响。由于常规阻抗-pH 变量的诊断灵敏度和可靠性并不理想，一些新的阻抗参数，例如吞咽后吞咽诱导的蠕动波指数和平均夜间基线阻抗，以及黏膜阻抗，正在进入验证阶段。一般临床使用。使用动态多管腔内阻抗-pH 准确诊断反刍综合征和胃上嗳气患者的行为障碍可以直接导致难治性胃食管反流病 (GERD) 患者的行为干预。新的刺激措施，例如多次快速吞咽和快速饮酒挑战，已经开发出来以克服标准高分辨率食管测压法的局限性，旨在进一步阐明食管动力障碍。此外，目前对食管干燥综合征和硬皮病患者（往往患有严重的 GERD）的诊断和治疗挑战正在进入一个新的研究和临床阶段。

更新日期：2020-07-05

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