Abnormal manometry - is this a show stopper for surgery?

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Brianala
Regular Member


Date Joined Apr 2014
Total Posts : 91
   Posted 5/22/2014 8:18 AM (GMT -6)   
I'll be circling back with my surgeon, of course, but I just got the results from my manometry and they were abnormal. Inadequate LES relaxation, hypertensive UES, 25% of swallows double peaked, and 8% of swallows failed.

Has anyone else had an abnormal manometry but still went ahead with surgery, or is this an automatic show stopper?

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 5/22/2014 11:39 AM (GMT -6)   
Hi Brianala,

I also have oesophageal motility problems and surgery is not an option for me, though that does not mean that this will be the case for you at all.
There have been plenty people on here who have motility problems who have had the surgery and are doing just fine.
May I ask what your LES relaxation percentage was, and your UES levels - you seem to have a couple of similar problems to myself.
Have you read up on the endostim, that's a good option for those with motility problems.

All the best,

Pink

Brianala
Regular Member


Date Joined Apr 2014
Total Posts : 91
   Posted 5/22/2014 11:44 AM (GMT -6)   
Thanks for the reply!

Here are the details from the report, it seems that it's not severe which is good, but I was so hopeful that I could proceed with surgery! It's good to hear it's not necessarily out of consideration.

LES pressure 39
UES pressure 124 (Hypertensive)
92% peristaltic, 8% failed swallows
26% double peaked

I will read up on endostim, thanks!
Hiatal Hernia, Esophagitis, Gastritis, Dysautonomia

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 5/22/2014 12:41 PM (GMT -6)   
Brianla,

Your LES pressure is quite high for someone with reflux, but although you are having some simultaneous contractions your overall score of 92% peristaltic does not sound abnormal at all, in fact quite good.
Your UES is high, but if you are having reflux into the throat that could be the cause of that, the highest mine has been at the UES is 196.

I don't think I would worry too much about your results, they sound pretty good to me.

I'm sure there will be others come along who will have more information than me.

All the best,

Pink

Brianala
Regular Member


Date Joined Apr 2014
Total Posts : 91
   Posted 6/20/2014 2:46 PM (GMT -6)   
Sorry for such a delay in replying to this, but what does the high LES pressure signify?
Hiatal Hernia, Esophagitis, Gastritis, Dysautonomia

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 6/22/2014 3:05 AM (GMT -6)   
Hi,

A normal les pressure ranges from 5-32 so theoretically if you have a good resting LES pressure of 39, your sphincter should be quite tight not allowing much reflux through.

It could be however that you are having transient openings of the sphincter.

Hope this helps,

Pink

Brianala
Regular Member


Date Joined Apr 2014
Total Posts : 91
   Posted 6/23/2014 8:59 AM (GMT -6)   
Thanks for that explanation, that helps put it in context! One more question, what does a hypertensive UES pressure mean? What is happening for the pressure there to be so high?

I've been unable to find an explanation online that I can understand.

Thanks!
Hiatal Hernia, Esophagitis, Gastritis, Dysautonomia

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 6/23/2014 4:01 PM (GMT -6)   
Hi,
A hypertensive UES is a high pressure in your upper oesophageal sphincter, this means that it is squeezing tightly to stop the reflux getting into your throat.

I had pressures of 196 and then got dysphagia from this - I suspect you are getting some reflux in your throat called LPR which makes the sphincter tighten and can proceed to spasms or a feeling of globus. I highly recommend an acid free diet, elevating your bed and gaviscon advance for the LPR.

If you look up LPR you will find a lot if information about it on this forum.

All the best,

Pink

Brianala
Regular Member


Date Joined Apr 2014
Total Posts : 91
   Posted 6/24/2014 2:49 PM (GMT -6)   
Thank you for the explanation, that makes sense!

Just scheduled my Nissen for August, so the manometry was not an issue!

I know it will be a long road ahead for recovery, but I can't wait to get started! Thanks for your support and help :)
Hiatal Hernia, Esophagitis, Gastritis, Dysautonomia
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