Digestive Physiology and Motility Studies Area
The functional studies of the digestive apparatus play a predominant role in the diagnosis of different medical processes, both anorectal or esophageal-gastric. The most relevant evidences in this sense are the esophageal manometry, the esophageal ph metry and the anorectal manometry.
The General and Digestive Surgery Department at Madrid Norte Sanchinarro Hospital includes this sophisticated diagnosis modality within its portfolio of services. The work of a high qualified professional in the field such as Dr. Federico Ochando as well as the use of modern technology make possible solving the challenges that our pacients bring about.
The esophageal manometry is the chosen technique for the quantitative and qualitative study of the motor activity of the esophagus. This technique is based on the simultaneous recording of pressure variations produced in the esophageal width at different levels.
1. Study of patients with functional dysphagia.
- Primary alterations on esophageal motility
- Diffuse esophageal spasm
- Nutcracker esophagus (symptomatic peristalsis)
- Inferior esophageal spasm
- Unspecific alterations
- Secondary alterations on esophageal motility
- Gastroesophageal reflux
- Connective-tissue disease
- Parkinson disease
- Pharyngeal dysphagia
- Neurological diseases
- Iatrogenic injuries
2. Study of gastroesophageal reflux disease patients
- Identification of high-risk patients
- Atypical symptoms
- Medical treatment failure
- Preoperative evaluation
3. Study of patients with (non-cardiac) chest pain
4. Generalized disease of the gastrointestinal tract
- Chronic idiopathic intestinal pseudo obstruction
5. Esophagus evaluation after therapy
- Pneumatic dilation in achalasia
- Postoperative management of anti-refluxm surgery
- Postoperative management of myotomy in achalasia
- Postoperative management of cricopharyngeal myotomy
Esophago-gastric ph metry
The continuous esophageal ph-monitoring is the most important diagnostic test in the diagnosis of the gastroesophageal reflux, but it is not sufficient to determine the cause of the disease.
Esophageal ph metry indications
1. Gastroesophageal reflux disease (suspicion or evidence)
- Atypical symptoms
- Evaluation of acid secretion suppression
- Lack of response to medical treatment
- Evaluation of the chronology of the gastroesophageal reflux
- Evaluation for anti-reflux surgery
Gastric ph metry: indications
1. Gastroesophageal reflux disease
- Suspicion of alteration of the gastric physiology
- Complement of the esophageal ph metry
2. Evaluation of the gastric secretion
- Reflujo gastro-esofágico
- Control de vagotomía
- Gastritis crónica
- Control de la medicación
The ano-rectal functional pathology causes different disorders that decrease the patients’ quality of life. It is estimated that about 26% of the population suffer from different sympthoms related to the anorectal area. In addition, 10 to 20% of the population suffer from fecal disorders.
The anorectal manometry is a technique that registers the anal canal pressure –both at rest or simulating physiologic situations- making the study of anorectal motility possible.
The anorectal manometry is the basic test for the study of the functional pathology of this anatomic area. This test must always be accompanied by an exhaustive medical record. In addition, in most cases, it is necessary to complement this test with other examinations such as the endoanal ultrasound, the video defecography, the endoscopy or the electromyography.
- Fecal incontinency (neurogenic, sensorial, muscular, traumatic, psycho organic, etc)
- Anorectal constipation
- Megacolon and-or Hirschsprung disease
- Pelvis floor pathology
- Fecal disfunction (anism)
- Anal Fissure
- Biofeedback in patients with continency and fecal alterations
- Preoperative evaluation of the sphincter function