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58 Measuring pyloric function using the functional lumen imaging probe
  1. S Bligh1,
  2. P Park2,
  3. M Bergstrom2,
  4. J Arroyo2,
  5. BP McMahon1
  1. 1TAGG Research Centre, Trinity College and Tallaght Hospital, Dublin, Ireland
  2. 2Dept of Surgery, Vaestra Hospital and Gothenburg University, Sweden

Abstract

Background Manometric studies are known to be inadequate in evaluating tone and opening patterns of digestive sphincters. The functional lumen imaging probe (FLIP) evolved as an important tool in evaluating sphincteric regions in the gastrointestinal tract.

Aim To evaluate the potential for this technique in a pilot study on a human volunteer to

1. Evaluate the efficiency and efficacy of placing and measuring with the probe endoscopically. 2. Demonstrate if the shape and function of the pylorus could be measured using this device. 3. Evaluate the effect of the administration of a pro-kenetic drug on the function of the pylorus.

Method One subject volunteered for the procedure as the probe is already approved for diagnostic use in the gastrointestinal tract. The EndoFLIP system (Crospon, Galway, Ireland) was set up as previously described using probe model EF-353. An Olympus therapeutic endoscope was inserted as per normal upper gastrointestinal investigation. The probe was inserted into the endoscope biopsy channel and positioned straddling the pylorus. Distension measurements were made with probe volumes of 20 ml, 30 ml and 40 ml before and after the administration of 10 mg of metoclopramide (Primperan).

Results Activity dramatically changed in the pylorus after Primperan. The narrowest region the sphincter measured using the minimum cross sectional (CSAmin) area was relatively inactive and stable before the drug but after the CSAmin varied significantly during the 20 s measurement window, indicating changes in activity.

Conclusions The FLIP system can successfully measure distensibility in the pylorus and these measurements may be useful in determining proper function in the region.

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