GI Motility Testing A Laboratory and Office Handbook

GI Motility Testing: A Laboratory and Office Handbookis a comprehensive and practical book that describes how to properly perform and interpret GI motility tests in conjunction with learning GI motility and neurogastroenterology. Drs. Henry P. Parkman, Richard W. McCallum, Satish S.C. Rao, and their contributors carefully detail the wide range of procedures that are used for the evaluation of patients in the GI motility laboratory. InsideGI Motility Testing,each chapter has been comprehensively written and fully illustrated with examples of tracings and studies. This detailed bookdiscusses the most up-to-date equipment and technology, while providing a solid understanding of normal and abnormal manometry patterns as well as information on billing and coding. Some Chapter Topics Include: Impedance Studies, High Resolution Manometry and Sensitivity Testing in Assessing Esophageal Disorders Gastric Emptying Scintigraphy Breath Testing for Carbohydrate Malabsorption and Bacterial Overgrowth Assessment of Gut Transit with Radiopaque Markers and Scintigraphy Novel Tests such as Wireless Motility Capsule for Evaluation of Regional and Whole Gut Transit/Motility Functional Brain Imaging in GI Neurophysiology Gastroesophageal Reflux Disease Gastroparesis Irritable Bowel Syndrome Constipation Fecal Incontinence GI Motility Testing: A Laboratory and Office Handbookcarefully explains how to integrate diagnostic information into decision making for day-to-day patient care, making it ideal for gastroenterologists, surgeons, GI fellows , internists, physician assistants, technicians, nurses, and nurse practitioners.

 Henry P. Parkman, MD, is Professor of Medicine in the Gastroenterology Section of the Department of Medicine at Temple University School of Medicine. Dr. Parkman’s gastroenterology training began with a GI fellowship at the University of Pennsylvania. His research investigated the inhibitory neural circuitry of the lower esophageal sphincter (LES)—the barrier preventing gastroesophageal reflux. At the University of Pennsylvania, he also compared the clinical outcomes and costs of pneumatic dilation and surgical esophagomyotomy for treatment of patients with achalasia, a disorder involving abnormal LES neural control. Dr. Parkman extended his research training with a National Institutes of Health research training fellowship in the Department of Physiology at Mayo Clinic where he studied the inferior mesenteric ganglion and its involvement in colonic motility.    

Dr. Parkman has been at Temple University School of Medicine for 20 years where he is Director of the Clinical GI Motility Laboratory at Temple University Hospital. He has developed expertise in a comprehensive array of GI motility tests for clinical evaluation of patients, including specialized tests of gastric motility. His clinical research studies have focused primarily on esophageal and gastric motility in normal individuals and on clinical motility disorders of the esophagus and stomach. His main clinical focus has been treating patients with GI motility disorders, primarily gastroparesis. Dr. Parkman is a past President of the American Neurogastroenterology and Motility Society. Dr. Parkman has been co-director of the ANMS Motility Courses held in 2002, 2004, 2006, 2008, and 2010.    

Richard W. McCallum, MD, FACP, FRACP (Aust), FACG, is Professor and Founding Chairman of the Department of Internal Medicine, Texas Tech University Health Sciences Center at El Paso. Dr. McCallum also serves as the Medical Director of the Diagnostic Center for GI Motility and Functional Bowel Disorders serving as a referral center for patients locally, regionally, and nationally.    

After completing his undergraduate studies at the University of Queensland, he earned his medical degree at the Queensland Medical School in Brisbane, Australia. Dr. McCallum completed gastroenterology fellowship training at the University of California Los Angeles and Wadsworth VA Medical Center. He joined the faculty of Yale University School of Medicine in 1996. Dr. McCallum was Professor of Medicine, Chief, and Program Director of the Division of Gastroenterology, Hepatology, and Nutrition at the University of Virginia School of Medicine, Charlottesville from 1985 to 1996 where he was awarded the Paul Janssen Endowed Chair and Professorship. From 1996 to 2004, Dr. McCallum was then Chief and Program Director, Division of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City. Dr. McCallum was the Director of the Center for GI Nerve and Muscle Function and Chief of Division of GI Motility, University of Kansas School of Medicine from 2004 to 2009.    

Among his professional honors and memberships are Fellow of the American College of Physicians, Fellow of the Royal Australian College of Physicians, Fellow of the American College of Gastroenterology, member of the American Society for Clinical Investigation, President of the Southern Society for Clinical Investigation, and President of the International Electrogastrogram Society. He is currently a member of the American Neurogastroenterology and Motility Society (ANMS) Council and has been Co-Director of the ANMS courses on Clinical Practice conducted in 2002, 2004, 2006, 2008 and 2010. He was the organizer and host for two national programs for ANMS in Charlottesville, Virginia in 1994 and Kansas City, Kansas in 2002.    

Dr. McCallum’s area of clinical interest and research is the field of GI motility, neurogastroenterology, and functional bowel disorders. He has been focused on advancing knowledge related to pathophysiology, diagnostic approaches, pharmacology, and device technology. He is a pioneer in the area of gut electrophysiology and developed the concept of electrical “pacing” of the stomach to treat gastroparesis, particularly related to diabetes mellitus. Recently he has rediscovered and extensively advanced new knowledge in understanding and managing a cyclic vomiting syndrome in adults.   

Satish S.C. Rao, MD, PhD, FRCP (Lon), received his MD from Osmania Medical College, Hyderabad, India; his PhD from the University of Sheffield, UK; and the Fellowship of the Royal College of Physicians (FRCP) in London, UK, in 1997. Currently, Dr. Rao is a Professor of Medicine and Director, Neurogastroenterology and GI Motility Program, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City.    

Dr. Rao is one of a rare breed of academicians who has excelled as an outstanding researcher, distinguished educator, and as a master clinician. Dr. Rao’s research interests focus on the pathophysiology and treatment of irritable bowel syndrome, constipation and fecal incontinence, and visceral pain, particularly esophageal chest pain, dietary fructose intolerance, and neurobiological mechanisms of biofeedback therapy. He has pioneered several new techniques of evaluating and treating motility disorders. He has received numerous awards including the American Gastroenterological Association (AGA) Distinguished Clinician Award, AGA Masters Award for Outstanding Clinical Research, and the AGA Distinguished Educator Award. In 2005, he also received the American College of Gastroenterology (ACG) Auxiliary Research Award, the highest research award from ACG. In 2009, he was awarded the International Foundation for Functional GI disorders Senior Clinical Investigator Award and in 2010 the University of Iowa Regents Award for Faculty Excellence.    

A very productive, federally funded investigator and sought-after speaker, Dr. Rao has edited 3 books, Disorders of the Anorectum (2001), Anorectal and Pelvic Floor Disorders (2008) for Gastroenterology Clinics of North America, and Gastrointestinal Motility—Testsand Problem-Oriented Approach. He has published more than 250 articles. Dr. Rao is a member of several distinguished medical and research societies. He is the current President of the American Neurogastroenterology and Motility Society.

Part A: Procedures Performed in the GI Motility Laboratory Section I Esophagus Chapter 1 Overview and Evaluation of Esophageal Symptoms Benson T. Massey, MD, FACP Chapter 2 Esophageal Manometry Javier Gomez, MD; Priyanka Sachdeva, MD; and Henry P. Parkman, MD Chapter 3 Esophageal pH Monitoring Srikant Muddana, MD, and Michael F. Vaezi, MD, PhD, MS (Epi) Chapter 4 Impedance Testing of Esophageal Motor Function and Reflux Radu Tutuian, MD, and Donald O. Castell, MD Chapter 5 Radiographic Evaluation of Esophageal Function: Barium Esophagography Elan Rosenthal, MD, and Dina F. Caroline, MD Chapter 6 Sensory Testing of the Esophagus Ronnie Fass, MD Section II Stomach and Small Intestine Chapter 7 Overview and Evaluation of Gastric Symptoms Rami El Abiad, MD; Bryan J. Feyen, DO; and Konrad S. Schulze, MD, FRCP(C) Chapter 8 Gastric Emptying Scintigraphy Alan H. Maurer, MD Chapter 9 Electrogastrography Jiande Chen, PhD; Zhiyue Lin, MS; and Jieyun Yin, MD Chapter 10 Antroduodenal Manometry William J. Snape, Jr, MD, and Linda Anh B. Nguyen, MD Chapter 11 Satiety Testing Michael Jones, MD, FACP, FACG Chapter 12 Gastric Volume and Accommodation Measurement by SPECT and Barostat Mhd Louai Manini, MD, and Michael Camilleri, MD Chapter 13 Ambulatory Capsule Tests for Assessment of GI Transit and Pressure Lenuta Kloetzer, MS; Satish S.C. Rao, MD, PhD, FRCP (Lon); and Braden Kuo, MD Chapter 14 Breath Testing for Gastric Emptying Seth Sweetser, MD, and Lawrence A. Szarka, MD Chapter 15 Breath Testing for Carbohydrate Intolerance Ashok Attaluri, MD, and Satish S.C. Rao, MD, PhD, FRCP (Lon) Chapter 16 Breath Tests for Small Intestine Bacterial Overgrowth Reza A. Hejazi, MD, and Richard W. McCallum, MD, FACP, FRACP (Aust), FACG Section III Colon and Anorectum Chapter 17 Overview and Evaluation of Colonic Symptoms Wendy A. Mikulski, DO, and Asyia S. Ahmad, MD Chapter 18 Anorectal Manometry Kasaya Tantiphlachiva, MD, and Satish S.C. Rao, MD, PhD, FRCP (Lon) Chapter 19 Biofeedback Therapy for Constipation Giuseppe Chiarioni, MD, and William E. Whitehead, PhD Color Atlas Chapter 20 Biofeedback Therapy (Neuromuscular Training) for Fecal Incontinence Elisabeth C. McLemore, MD, and Dana R. Sands, MD, FACS, FASCRS Chapter 21 Assessment of Colonic Transit: Radiopaque Markers, Scintigraphy, and Wireless Motility Capsule Henry P. Parkman, MD; Javier Gomez, MD; and Satish S.C. Rao, MD, PhD, FRCP (Lon) Chapter 22 Rectal Barostat for Sensory Testing S. Mark Scott, PhD, and Marc A. Gladman, PhD, MRCOG, FRCS (Gen Surg) Chapter 23 Anorectal Imaging With Magnetic Resonance Imaging, Barium Defecography, and Ultrasound Adil E. Bharucha, MBBS, MD, and Joel G. Fletcher, MD Chapter 24   Colonic Manometry Rosa Burgers, MD; Carlo Di Lorenzo, MD; and Satish S.C. Rao, MD, PhD, FRCP (Lon) Section IV Miscellaneous Topics and Procedures Chapter 25 Establishing a GI Motility Laboratory William C. Orr, PhD Chapter 26 Functional Brain Imaging in GI Neurophysiology Howard R. Mertz, MD Chapter 27 Pediatric and Adolescent GI Motility Testing Ann Aspirot, MD, FRCPC, and Hayat Mousa, MD, FAAP Chapter 28 GI Hormone Testing Reza A. Hejazi, MD, and Richard W. McCallum, MD, FACP, FRACP (Aust), FACG Part B: GI Motility Disorders Section V Esophagus Chapter 29 Gastroesophageal Reflux Disease Ellen Stein, MD, and Philip O. Katz, MD Chapter 30 Achalasia, Diffuse Esophageal Spasm, and Other Esophageal Motility Disorders Zeeshan Ramzan, MD, and Joel E. Richter, MD, FACP, MACG Section VI Stomach Chapter 31 Gastroparesis Emori B. Bizer, MD, and John M. Wo, MD Chapter 32 Functional Dyspepsia Richard Saad, MD, and William D. Chey, MD, AGAF, FACG, FACP Section VII Small Intestine Chapter 33 Chronic Intestinal Pseudo-Obstruction Robert W. Summers, MD Chapter 34 Small Intestinal Bacterial Overgrowth Mark Pimentel, MD, FRCP(C) Section VIII Colon and Anorectum Chapter 35 Chronic Constipation Arnold Wald, MD Chapter 36 Fecal Incontinence Adil E. Bharucha, MBBS, MD Chapter 37 Irritable Bowel Syndrome Elizabeth J. Videlock, MD, and Lin Chang, MD Chapter 38 Gas/Bloat Syndromes William L. Hasler, MD Section IX Diffuse GI Disorders Chapter 39 Scleroderma and Collagen Vascular Disorders Deborah M. Bethards, MD, and Ann Ouyang, MD Chapter 40 GI Complications of Diabetes Mellitus Eva Sum, MD, and Robert S. Fisher, MD Chapter 41 Visceral Hypersensitivity Klaus Bielefeldt, MD, PhD Financial Disclosures Index