European Society for Neurogastroenterology and Motility (ESNM) recommendations for the use of high‐resolution manometry of the esophagus. Issue 5 (4th December 2020)

• Record Type: Journal Article
• Authors: Tack, Jan; Pauwels, Ans; Roman, Sabine; Savarino, Edoardo; Smout, André
• Other Names: Akyuz Filiz investigator.; Bancila Ion investigator.; Barrias Silvia investigator.; Bor Serhat investigator.; Borovicka Jan investigator.; Bredenoord Albert J investigator.; Brochard Charlene investigator.; Buckley Martin investigator.; Carter Dan investigator.; Ciriza de los Rios Constanca investigator.; Conchillo Jose investigator.; De Bortoli Nicola investigator.; De Schepper Heiko investigator.; Dickman Ram investigator.; Dumatriscu Dan investigator.; Hatlebakk Jan investigator.; Hoff Dag Arne investigator.; Jurcic Dragan investigator.; Keller Jutta investigator.; Novais Luis investigator.; Pehl Christian investigator.; Penagini Roberto investigator.; Rommel Nathalie investigator.; Ron Yishai investigator.; Vaquero Cecilio Santander investigator.; Sifrim Daniel investigator.; Souto Paulo investigator.; Storonova Olga investigator.; Troskot Rosana investigator.; Trukhmanov Alexander investigator.; Tutuian Radu investigator.; Woodland Philip investigator.; Zerbib Frank investigator.;
• Is Part Of: Neurogastroenterology & motility. Volume 33:Issue 5(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-04
• Subjects: achalasia -- belching -- chest pain -- Chicago classification -- esophageal manometry -- impedance manometry -- rumination -- solid state catheter -- spasm; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.14043
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: Several patients in gastroenterology practice present with esophageal symptoms, and in case of normal endoscopy with biopsies, high‐resolution manometry (HRM) is often the next step. Our aim was to develop a European consensus on the clinical application of esophageal HRM, to offer the clinician guidance in selecting patients for HRM and using its results to optimize clinical outcome. Methods: A Delphi consensus was initiated with 38 multidisciplinary experts from 16 European countries who conducted a literature summary and voting process on 71 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 33 statements. Results: The process generated guidance on when to consider esophageal HRM, how to perform it, and how to generate the report. The Delphi process also identified several areas of uncertainty, such as the choice of catheters, the duration of fasting and the position in which HRM is performed, but recommended to perform at least 10 5‐ml swallows in supine position for each study. Postprandial combined HRM impedance is considered useful for diagnosing rumination. There is a large lack of consensus on treatment implications of HRM findings, which is probably the single area requiring future targeted research. Conclusions and inferences: A multinational and multidisciplinary group of European experts summarized the current state of consensus on technical aspects, indications, performance, analysis, diagnosis, and therapeutic implications of esophageal HRM. Abstract : Statements and their endorsement in the European Society for Neurogastroenterology and Motility Recommendations for the use of high‐resolution manometry of the esophagus.