S856 Patient Tolerance of Unsedated Endoluminal Functional Lumen Imaging Probe and High-Resolution Manometry in a Tertiary Care Center in Canada
Bibliographic record
Abstract
Introduction: The endoluminal functional lumen imaging probe (FLIP) is a transoral catheter-based tool used to aid in the diagnosis of esophageal motility disorders. The standard of care is performing FLIP at time of sedated endoscopy. This can pose challenges in a resource constrained setting. Esophageal manometry (HRM), involving the transnasal placement of a catheter in an unsedated patient, has a success rate of >99%. In our center, we perform FLIP in unsedated patients in the motility lab. Our study aimed to compare the tolerability and overall success of esophageal manometry and unsedated esophageal FLIP. Methods: We conducted a prospective cross-sectional study of patients that underwent HRM or unsedated esophageal FLIP between August 2023 and April 2025. Patients were provided a questionnaire following the procedure to track adverse events during catheter insertion and recording. Data on tolerability was collected, as were other demographic- and outcome-related parameters. The incidence of patient-reported adverse effects was compared with Chi-squared tests and the intensity of pain on a 10-point visual analogue scale and overall experience were compared with Mann-Whitney U. Results: A total of 88 patients (62 [70.5%] women, median age 58.5 years) underwent HRM (61 [69.3%]) or FLIP (27 [30.7%]) and were included in this analysis. There was no significant difference between reported adverse events occurring during FLIP versus HRM except for ‘other,’ reported in 37% FLIP and 11% HRM (P = .007) during insertion. Gagging was reported by 30% and pain/pressure by 7% FLIP patients and gagging by 11% HRM patients. During recording, vomiting was reported by 16% HRM patients vs 0% FLIP (P = .029). In terms of overall experience, global distress was statistically different with a median score of 3 for FLIP and 2 for HRM (P = .017). There was no difference in global symptoms between age <65 and age >65, or sex. There was no difference in overall success between FLIP and HRM with technical success seen in 93% FLIP and 95% HRM (P = 0.49). Conclusion: There are no significant differences between adverse events associated with FLIP versus HRM, except for gagging at time of insertion, which was higher in FLIP patients. However, there was no difference in overall success between both procedures suggesting that unsedated FLIP is well tolerated and safe to perform in the motility lab.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".