Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
Neurogastroenterol Motil. 2024 Nov;36(11):e14907. doi: 10.1111/nmo.14907. Epub 2024 Sep 2.
The diagnosis of small bowel motility disorders is performed by manometric evaluation of the contractile patterns of the small intestine. Conventional intestinal manometry systems include few pressure sensors at relatively long intervals. We have recently shown that high-resolution jejunal manometry, with multiple closely spaced recording sites, allows the analysis of propagation patterns of intestinal motility in healthy subjects that cannot be detected with conventional manometry. The objective of this pilot study was to explore the feasibility and diagnostic value of high-resolution intestinal manometry in patients with suspected small bowel dysmotility.
Prospective pilot study evaluating intestinal motility patterns in 16 consecutive patients (16-61 years; 11 women) with severe, chronic digestive symptoms referred for the evaluation of intestinal motility and in 18 healthy controls (21-38 years; 8 women). A 36-channel high-resolution manometry catheter was orally placed under radiological guidance in the jejunum. Intestinal motility was continuously recorded for 3 h fasting and 2 h after a 450 kcal meal. The manometric recordings were analyzed in two formats: (a) with the high-resolution data from 34 channels and (b) showing only the recordings from 5 channels separated by 7 cm intervals, mimicking a conventional manometry recording.
In the analysis mimicking conventional manometry, abnormal motility criteria were detected in six patients and in no healthy subject [bursts (n = 3), postprandial minute rhythm (n = 1) and myopathic pattern (n = 2)]. These classical dysmotility criteria were also detected by high-resolution manometry. High-resolution analysis detected one or more abnormal findings in seven additional patients that were not observed in any healthy subject, specifically: (a) abnormal propagation of Phase III (n = 3); (b) reduced propagated activity during Fasting Phase II (n = 4); (c) increased propagated activity during Fasting Phase II and postprandial phase (n = 1).
This pilot study suggests that high-resolution intestinal manometry may improve the sensitivity of conventional manometry in the detection of intestinal motor dysfunction.
小肠运动障碍的诊断是通过对小肠收缩模式的压力测量来完成的。传统的肠道测压系统包括相对较长间隔的几个压力传感器。我们最近发现，具有多个紧密间隔记录点的高分辨率空肠测压法可以分析健康受试者的肠道运动传播模式，而这些模式无法通过传统测压法检测到。本研究的目的是探索高分辨率肠道测压在疑似小肠运动障碍患者中的可行性和诊断价值。
前瞻性研究评估了 16 例连续患者（16-61 岁；11 名女性）和 18 例健康对照者（21-38 岁；8 名女性）的肠道运动模式。在放射引导下将 36 通道高分辨率测压管经口置于空肠内。在禁食 3 小时和餐后 2 小时内持续记录肠道运动。对测压记录进行了两种格式的分析：（a）用 34 个通道的高分辨率数据，（b）仅显示间隔 7cm 的 5 个通道的记录，模拟传统测压记录。
在模拟传统测压的分析中，6 例患者出现异常运动标准，而健康对照者无一例出现[爆发（n=3）、餐后分钟节律（n=1）和肌病模式（n=2）]。这些经典的运动障碍标准也通过高分辨率测压法检测到。高分辨率分析还在另外 7 例患者中检测到一个或多个异常发现，而这些发现均未在任何健康受试者中观察到，具体包括：（a）III 期异常传播（n=3）；（b）空腹期 II 期传播活动减少（n=4）；（c）空腹期 II 期和餐后期传播活动增加（n=1）。
本研究表明，高分辨率肠道测压可能提高传统测压法检测肠道运动功能障碍的敏感性。
