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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Aug 15, 2015; 6(3): 58-61
Published online Aug 15, 2015. doi: 10.4291/wjgp.v6.i3.58
Can high resolution manometry parameters for achalasia be obtained by conventional manometry?
Fernando AM Herbella, Marco G Patti
Fernando AM Herbella, Hospital Sao Paulo, Surgical Gastroenterology, Division of Esophagus and Stomach, Federal University of Sao Paulo, Sao Paulo 04037-003, Brazil
Marco G Patti, Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, United States
Author contributions: Herbella FAM contributed to conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval of the version to be published; Patti MG contributed to analysis and interpretation of data, review for intellectual content, final approval of the version to be published.
Conflict-of-interest statement: There are none. All authors contributed sufficiently to be named as authors and are responsible for the manuscript, no professional or ghost writer was hired.
Correspondence to: Dr. Fernando AM Herbella, MD, Hospital Sao Paulo, Surgical Gastroenterology, Division of Esophagus and Stomach, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo 04037-003, Brazil. herbella.dcir@epm.br
Telephone: +55-11-99922824 Fax: +55-11-39267610
Received: March 20, 2015
Peer-review started: March 22, 2015
First decision: April 10, 2015
Revised: April 22, 2015
Accepted: May 7, 2015
Article in press: May 8, 2015
Published online: August 15, 2015
Processing time: 149 Days and 20 Hours
Abstract

High resolution manometry (HRM) is a new technology that made important contributions to the field of gastrointestinal physiology. HRM showed clear advantages over conventional manometry and it allowed the creation of different manometric parameters. On the other side, conventional manometry is still wild available. It must be better studied if the new technology made possible the creation and study of these parameters or if they were always there but the colorful intuitive panoramic view of the peristalsis from the pharynx to the stomach HRM allowed the human eyes to distinguish subtle parameters unknown or uncomprehend so far and if HRM parameters can be reliably obtained by conventional manometry and data from conventional manometry still can be accepted in achalasia studies. Conventional manometry relied solely on the residual pressure to evaluate lower esophageal sphincter (LES) relaxation while HRM can obtain the Integrated Relaxation Pressure. Esophageal body HRM parameters defines achalasia subtypes, the Chicago classification, based on esophageal pressurization after swallows. The characterization of each subtype is very intuitive by HRM but also easy by conventional manometry since only wave amplitudes need to be measured. In conclusion, conventional manometry is still valuable to classify achalasia according to the Chicago classification. HRM permits a better study of the LES.

Keywords: Achalasia; Esophagus; High resolution manometry; Conventional manometry; Lower esophageal sphincter; Esophageal body; Chicago classification

Core tip: High resolution manometry is a new technology with clear advantages over conventional manometry. It is unclear; however, if new parameters created after this technology can be obtained by conventional manometry especially in achalasia cases. We found that conventional manometry is still valuable to classify achalasia according to the Chicago classification but high resolution manometry permits a better study of the lower esophageal sphincter.