Figure 2 Metrics from oesophageal high-resolution

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Figure 2 Metrics from oesophageal high-resolution manometry used in the characterization of motor function in GERD Figure 2 | Metrics from oesophageal high-resolution manometry used in the characterization of motor function in GERD. a | Basal and end-expiratory resting pressures are obtained during a period of quiet rest. The oesophagogastric junction contractile integral (EGJ-CI) assesses vigour of the EGJ barrier, taking into account the length and amplitude of pressure of the EGJ above the gastric baseline, corrected for respiration. EGJ morphology is assessed by determining the relationship between the intrinsic lower esophageal sphincter (LES) and the crural diaphragm. b | The vigour of oesophageal smooth muscle contraction is assessed using the distal contractile integral (DCI), a measure of the amplitude, length and duration of smooth muscle contraction, normally >450 mmHg·cm·s. DCI <450 mmHg·cm·s indicates ineffective peristalsis, whereas DCI <100 mmHg·cm·s indicates failed peristalsis. If DCI is normal but there is a >5 cm break in peristaltic integrity, the sequence is designated fragmented. c | Response to multiple rapid swallows (MRS) consists of an augmented contraction sequence following inhibition of peristalsis during the repetitive swallows. Contraction reserve indicates that the DCI of contraction following MRS is higher than the mean DCI from test swallows (ratio >1). Savarino, E. et al. (2017) Advances in the physiological assessment and diagnosis of GERD Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2017.130