Guiding Manometry Probes into the Human Small Bowel without X-Ray: Validation of a New Technique

Abstract

Background: In order to perform small bowel manometry studies in man, the probes have to be guided through the upper gastrointestinal tract. This is usually controlled by fluoroscopy, but a method that allows to place the tubes without X-rays is obviously desirable. Methods: A new method that controls tube placing by sonography and pH-metry instead of X-rays is described. In a total of 19 volunteers 40 tubes were placed, either under fluoroscopic control (n = 22) or without X-rays (n = 18). Results: Nose to antrum time was not significantly different between the two groups (8 ± 2 vs. 10 ± 2 min), but the documented transit of the tube from the antrum into the duodenum was significantly slower in the fluoroscopy group (80 ± 20 vs. 60 ± 12 min). Small bowel transit time was not significantly different between the groups (73 ± 16 vs. 65 ± 15 min). Conclusion: Placing motility probes in the human small bowel can be controlled by sonography and pH-metry instead of fluoroscopy. It is also easily performed, faster and more convenient for the investigator. As far as basic gastrointestinal research is concerned, in Germany less bureaucratic paperwork is involved, as these studies need not be approved by the ‘Bundesamt für Strahlenschutz’ any more.