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Double-Peaked High-Pressure Zone at the Esophagogastric Junction in Controls and in Patients with a Hiatal Hernia: A Study Using High-Resolution Manometry

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Abstract

The lower esophageal high-pressure zone (HPZ) consists of the intrinsic lower esophageal sphincter (LES) and the diaphragmatic sphincter. In patients with a hiatal hernia these constituents are separated. We performed high-resolution manometry of the esophagogastric HPZ in six controls, six patients with a small hernia, and six patients with a large hernia. Prevalence of a double-peak pressure profile of the HPZ was noted. Pressures and distances between the peaks were assessed. Prevalence of the double-peak profile was similar between patients with a small hernia and controls, but patients with a large hernia showed a higher prevalence with inspiration (P<0.05) than the others. The distance between the two peaks was larger in patients with a large hernia (P<0.05). In conclusion, high-resolution manometry makes it possible to distinguish the diaphragmatic pressure component from the LES. Two pressure peaks can be found both in hernia patients and in healthy volunteers.

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Authors and Affiliations

  1. Department of Gastroenterology, Sint Antonius Hospital, Nieuwegein, The Netherlands

    A. J. Bredenoord & B. L. A. M. Weusten

  2. Gastrointestinal Research Unit, Department of Gastroenterology, University Medical Center, Utrecht, The Netherlands

    S. Carmagnola & A. J. P. M. Smout

Authors
  1. A. J. Bredenoord
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  2. B. L. A. M. Weusten
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  3. S. Carmagnola
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  4. A. J. P. M. Smout
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Correspondence to A. J. Bredenoord.

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Bredenoord, A.J., Weusten, B.L.A.M., Carmagnola, S. et al. Double-Peaked High-Pressure Zone at the Esophagogastric Junction in Controls and in Patients with a Hiatal Hernia: A Study Using High-Resolution Manometry. Dig Dis Sci 49, 1128–1135 (2004). https://doi.org/10.1023/B:DDAS.0000037799.29678.94

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  • DOI: https://doi.org/10.1023/B:DDAS.0000037799.29678.94

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