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RISS 인기검색어
- 검색키워드
- 저자 : Askin Erdogan (검색결과 3 건)
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( Yeong Yeh Lee ),( Askin Erdogan ),( Satish S C Rao ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.2
Assessment of transit through the gastrointestinal tract provides useful information regarding gut physiology and pathophysiology. Although several methods are available, each has distinct advantages and limitations. Recently, an ingestible wirelessmotility capsule (WMC), similar to capsule video endoscopy, has become available that offers a less-invasive, standardized,radiation-free and office-based test. The capsule has 3 sensors for measurement of pH, pressure and temperature, and collectivelythe information provided by these sensors is used to measure gastric emptying time, small bowel transit time, colonictransit time and whole gut transit time. Current approved indications for the test include the evaluation of gastric emptyingin gastroparesis, colonic transit in constipation and evaluation of generalised dysmotility. Rare capsule retention and malfunctionare known limitations and some patients may experience difficulty with swallowing the capsule. The use of WMC has beenvalidated for the assessment of gastrointestinal transit. The normal range for transit time includes the following: gastric emptying(2-5 hours), small bowel transit (2-6 hours), colonic transit (10-59 hours) and whole gut transit (10-73 hours). Besidesavoiding the use of multiple endoscopic, radiologic and functional gastrointestinal tests, WMC can provide new diagnoses,leads to a change in management decision and help to direct further focused work-ups in patients with suspected disorderedmotility. In conclusion, WMC represents a significant advance in the assessment of segmental and whole gut transit and motility,and could prove to be an indispensable diagnostic tool for gastrointestinal physicians worldwide
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( Yeong Yeh Lee ),( Askin Erdogan ),( Satish S C Rao ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.4
Management of chronic constipation with refractory symptoms can be challenging. Although new drugs and behavioral treatments have improved outcome, when they fail, there is little guidance on what to do next. At this juncture, typically most doctors may refer for surgical intervention although total colectomy is associated with morbidity including complications such as recurrent bacterial overgrowth. Recently, colonic manometry with sensory/tone/compliance assessment with a barostat study has been shown to be useful. Technical challenges aside, adequate preparation, and appropriate equipment and knowledge of colonic physiology are keys for a successful procedure. The test itself appears to be safe with little complications. Currently, colonic manometry is usually performed with a 6-8 solid state or water-perfused sensor probe, although high-resolution fiber-optic colonic manometry with better spatiotemporal resolutions may become available in the near future. For a test that has evolved over 3 decades, normal physiology and abnormal findings for common phenotypes of chronic constipation, especially slow transit constipation, have been well characterized only recently largely through the advent of prolonged 24-hour ambulatory colonic manometry studies. Even though the test has been largely restricted to specialized laboratories at the moment, emerging new technologies and indications may facilitate its wider use in the near future.
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Yeong Yeh Lee,Askin Erdogan,Siegfried Yu,Annie Dewitt,Satish S C Rao 대한소화기 기능성질환∙운동학회 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.3
Background/Aims Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known. Methods Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down “on-bed” without inflated rectal balloon and “on-commode (toilet)” with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated. Results Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed. Conclusions Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.
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