Functional Luminal Imaging Probe in the Management of Pediatric Esophageal Disorders

The pressure-geometry correlations of the luminal space of the digestive tract are measured with the functional luminal imaging probe (FLIP). It gives several luminal features that aid in understanding the pathophysiology of esophageal problems when applied in this way. There is little data on the potential value of FLIP in pediatrics and there is no standardized use in children. For a study, researchers wanted to explain the use of FLIP in their institution, as well as its safety, usefulness, and clinical impact on pediatric esophageal disease. FLIP recordings were retrieved from the hospital between February 2018 and January 2021. A map check was performed for demographics and medical history. Symptomatology after surgery was assessed using established dysphagia measures.

Approximately 19 patients with achalasia (n=5), post-myotomy Heller’s dysphagia (n=3), esophagogastric junction outflow blockage (n=3), congenital esophageal stenosis (n=2); post-esophageal atresia repair stricture (n = 3), and post-fundoplication dysphagia (n = 3) were included. There was no significant association between integrated relaxation pressure and extensibility index as determined by high resolution manometry (DI). Using FLIP, we were able to distinguish between dysphagia caused by esophageal obstruction (DI <2.8 mm2/mmHg) and dysphagia caused by a significant motility issue (DI > 2.8 mm2/mmHg), which informed the recommendation for dilation. FLIP led to a change in management in 47% of patients. At the time of the study, 47% of patients were asymptomatic. FLIP provided crucial esophageal luminal parameters and thus could play an important role in the therapy of juvenile esophageal disease.

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