Inclusion criteria:
1. Subjects will be of either sex, 18 to 70 years of age.
patients with an established diagnosis of gastroparesis, either diabetic or idiopathic etiology. The gastroparesis subjects will have delayed gastric emptying on gastric scintigraphy defined as greater than 60% retention at 2 hours and/or greater than 10% retention at 4 hours. This gastric emptying test would have been done prior to the endoscopy and is not part of the research study. Patients will undergo EndoFlip during upper endoscopy.

Inclusion criteria:
1. Subjects will be of either sex, 18 to 70 years of age.
control subjects will be nondiabetic patients without gastroparesis or gastroesophageal reflux symptoms undergoing upper endoscopy. Patients will undergo EndoFlip during upper endoscopy.

Gastroparesis

Measurement of pyloric resistance and compliance

EndoFLIP

Temple University Hospital

Pyloric Sphincter Pressure and Geometry Assessment Using EndoFlip

Measurement of pyloric pressure using EndoFLIP in patients with gastroparesis and controls. Our plan is to compare the pyloric pressures in patients with gastroparesis to controls. This is an observational study with no intervention.

Henry P. Parkman, MD

Professor of Medicine

Temple University

Patients randomized to receive cricoid pressure during endotracheal intubation.

Patients randomized to receive no cricoid pressure during endotracheal intubation.

Microaspiration

Acute Respiratory Distress Syndrome (ARDS)

Hospital Acquired Pneumonia

Firm pressure on the cricoid cartilage with the goal of occluding the esophagus during endotracheal intubation.

Cricoid pressure

Mayo Clinic - Saint Mary's Campus

Mayo Clinic in Rochester

Does Cricoid Pressure Reduce the Risk of Aspiration?

Tracheal secretions will be collected and later analyzed for the presence of pepsin A.

John (J Kyle) K. Bohman, M.D.

Instructor of Anesthesiology

Mayo Clinic

Alfred I. duPont Hospital for Children

patients with hiatal or paraesophageal hernias

patients without hiatal or paraesophageal hernias who are undergoing crural dissection for heller myotomy, or who are undergoing gastric bypass surgery

small tissue biopsies of gastrohepatic, gastrophrenic, and phrenoesophageal ligaments

esophageal achalasia/nutukimas

Pyloric Sphincter Pressure and Geometry Assessment Using EndoFlip

Does Cricoid Pressure Reduce the Risk of Aspiration?

The Biologic Basis of Hernia Formation

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