Correlation Between Clinical Signs and High-resolution Manometry Data in Children
Corresponding Author
Marine Juzaud
Service de pédiatrie multidisciplinaire, La Timone Children's Hospital, Marseille
Address correspondence and reprint requests to Marine Juzaud, MD, MS, Service de pédiatrie multidisciplinaire, CHU La Timone, APHM, 264 Rue Saint Pierre, 13005 Marseille 05, Provence-Alpes-Côte d'Azur, France (e-mail: [email protected]).Search for more papers by this authorMarie-Dominique Lamblin
Clinical Neurophysiology Department, Lille University Hospital, Lille
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorAlexandre Fabre
Service de pédiatrie multidisciplinaire, La Timone Children's Hospital, Marseille
Aix Marseille Université, INSERM, MMG, Marseille
Search for more papers by this authorMarine Alessandrini
EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille
Search for more papers by this authorKarine Baumstarck
EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille
Search for more papers by this authorCamille Bazin
Department of Gastroenterology, North Hospital, Assistance Publique – Hôpitaux de Marseille, Marseille
Search for more papers by this authorClothilde Esteve
INSERM U1251 MMG Marseille Medical Genetics Aix-Marseille Université, Marseille
Search for more papers by this authorNolwenn Laborde
Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
Université de Toulouse, UPS, Toulouse, France
Search for more papers by this authorLindsay Osei
Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, French Guiana
Search for more papers by this authorLaurent Michaud
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorFrederic Gottrand
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorVeronique Vitton
Department of Gastroenterology, North Hospital, Assistance Publique – Hôpitaux de Marseille, Marseille
Search for more papers by this authorCorresponding Author
Marine Juzaud
Service de pédiatrie multidisciplinaire, La Timone Children's Hospital, Marseille
Address correspondence and reprint requests to Marine Juzaud, MD, MS, Service de pédiatrie multidisciplinaire, CHU La Timone, APHM, 264 Rue Saint Pierre, 13005 Marseille 05, Provence-Alpes-Côte d'Azur, France (e-mail: [email protected]).Search for more papers by this authorMarie-Dominique Lamblin
Clinical Neurophysiology Department, Lille University Hospital, Lille
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorAlexandre Fabre
Service de pédiatrie multidisciplinaire, La Timone Children's Hospital, Marseille
Aix Marseille Université, INSERM, MMG, Marseille
Search for more papers by this authorMarine Alessandrini
EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille
Search for more papers by this authorKarine Baumstarck
EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, Marseille
Search for more papers by this authorCamille Bazin
Department of Gastroenterology, North Hospital, Assistance Publique – Hôpitaux de Marseille, Marseille
Search for more papers by this authorClothilde Esteve
INSERM U1251 MMG Marseille Medical Genetics Aix-Marseille Université, Marseille
Search for more papers by this authorNolwenn Laborde
Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
Université de Toulouse, UPS, Toulouse, France
Search for more papers by this authorLindsay Osei
Department of Pediatrics, Andrée Rosemon Hospital, Cayenne, French Guiana
Search for more papers by this authorLaurent Michaud
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorFrederic Gottrand
Pediatric Gastroenterology Department, Hepatology and Nutrition, Reference Center for Rare Esophageal Diseases, CHU Lille, University Lille, Lille
Search for more papers by this authorVeronique Vitton
Department of Gastroenterology, North Hospital, Assistance Publique – Hôpitaux de Marseille, Marseille
Search for more papers by this authorThe authors report no conflicts of interest.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org).
ABSTRACT
Objectives:
High-resolution manometry (HRM) is the gold standard for diagnosis of esophageal motility disorders. However, clinical signs associated with these disorders are nonspecific, and it is difficult to correlate clinical signs with HRM data. The main objective of our study was to assess the positive predictive value (PPV) and negative predictive value (NPV) of each clinical sign, as well as their sensitivity and specificity in the diagnosis of esophageal motility disorders.
Methods:
This is a bicentric retrospective cohort study based on HRM data collected between May 2012 and May 2016. The studied symptoms were weight loss, feeding difficulties, swallowing disorders, dysphagia, food blockages, vomiting, gastroesophageal reflux disease (GERD), belching, and respiratory symptoms. HRM data were analyzed according to the Chicago Classification (3.0).
Results:
In total, 271 HRM data were analyzed, of which 90.4% showed abnormal results. HRM was well tolerated in 91% of the cases. The most common esophageal motility disorder was ineffective esophageal motility (38%). Weight loss was significantly associated (P = 0.003) with an abnormal HRM with a 96% PPV.
Conclusions:
With nonspecific clinical signs suggesting an esophageal motility disorder, weight loss was a predictive sign of abnormal HRM results. HRM was well tolerated in pediatric patients, and ineffective esophageal motility appears to be the most frequent motility disorder in our cohort, as already observed in adult patient studies.
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