Esophageal distensibility measurement: impact on clinical management and procedure length

Nita Ahuja, A. Agnihotri, K. L. Lynch, D. Hoo-Fatt, F. Onyimba, M. McKnight, F. C. Okeke, P. Garcia, S. Dhalla, Ellen Stein, Pankaj Jay Pasricha, J. O. Clarke

Research output: Contribution to journalArticle

Abstract

Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months. Procedural data were prospectively collected and, along with medical records, retrospectively reviewed. Seventy-three procedures (70 patients) underwent esophageal distensibility measurement over the timeline of this study. The most common procedural indications were known or suspected achalasia (32.9%), dysphagia with connective tissue disease (13.7%), eosinophilic esophagitis (12.3%), and dysphagia with prior fundoplication (9.6%). FLIP results independently led to a change in management in 29 (39.7%) cases and supported a change in management in an additional 15 (20.5%) cases. The most common change in management was a new or amended therapeutic procedure (79.5%). Procedural time added by distensibility measurement was greater among earlier cases than among later cases. The median time added overall was 5 minutes and 46 seconds. Procedural time added varied significantly by procedural indication, but changes in management did not. Distensibility measurement added meaningful diagnostic information that impacted therapeutic decision-making in the majority of cases in which it was performed. Procedural time added by this modality is typically modest and decreases with experience.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalDiseases of the Esophagus
Volume30
Issue number8
DOIs
StatePublished - Aug 1 2017

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Deglutition Disorders
Eosinophilic Esophagitis
Fundoplication
Esophageal Achalasia
Connective Tissue Diseases
Learning Curve
Electric Impedance
Esophagus
Endoscopy
Medical Records
Decision Making
Therapeutics
Clinical Decision-Making
TimeLine

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Ahuja, N., Agnihotri, A., Lynch, K. L., Hoo-Fatt, D., Onyimba, F., McKnight, M., ... Clarke, J. O. (2017). Esophageal distensibility measurement: impact on clinical management and procedure length. Diseases of the Esophagus, 30(8), 1-8. https://doi.org/10.1093/dote/dox038

Esophageal distensibility measurement : impact on clinical management and procedure length. / Ahuja, Nita; Agnihotri, A.; Lynch, K. L.; Hoo-Fatt, D.; Onyimba, F.; McKnight, M.; Okeke, F. C.; Garcia, P.; Dhalla, S.; Stein, Ellen; Pasricha, Pankaj Jay; Clarke, J. O.

In: Diseases of the Esophagus, Vol. 30, No. 8, 01.08.2017, p. 1-8.

Research output: Contribution to journalArticle

Ahuja, N, Agnihotri, A, Lynch, KL, Hoo-Fatt, D, Onyimba, F, McKnight, M, Okeke, FC, Garcia, P, Dhalla, S, Stein, E, Pasricha, PJ & Clarke, JO 2017, 'Esophageal distensibility measurement: impact on clinical management and procedure length', Diseases of the Esophagus, vol. 30, no. 8, pp. 1-8. https://doi.org/10.1093/dote/dox038
Ahuja, Nita ; Agnihotri, A. ; Lynch, K. L. ; Hoo-Fatt, D. ; Onyimba, F. ; McKnight, M. ; Okeke, F. C. ; Garcia, P. ; Dhalla, S. ; Stein, Ellen ; Pasricha, Pankaj Jay ; Clarke, J. O. / Esophageal distensibility measurement : impact on clinical management and procedure length. In: Diseases of the Esophagus. 2017 ; Vol. 30, No. 8. pp. 1-8.
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