Skip to main content
Journal cover image

Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology.

Publication ,  Journal Article
Price, LH; Li, Y; Patel, A; Gyawali, CP
Published in: Neurogastroenterol Motil
May 2014

BACKGROUND: Multiple rapid swallows (MRS) during esophageal high resolution manometry (HRM) assess esophageal neuromuscular integrity by evaluating postdeglutitive inhibition and rebound contraction, but most reports performed only a single MRS sequence. We assessed patterns of MRS reproducibility during clinical HRM in comparison to a normal cohort. METHODS: Consecutive clinical HRM studies were included if two separate MRS sequences (four to six rapid swallows ≤4 s apart) were successfully performed. Chicago Classification diagnoses were identified; contraction wave abnormalities were additionally recorded. MRS-induced inhibition (contraction ≤3 cm during inhibition phase) and rebound contraction was assessed, and findings compared to 18 controls (28.0 ± 0.7 year, 50.0% female). Reproducibility consisted of similar inhibition and contraction responses with both sequences; discordance was segregated into inhibition and contraction phases. KEY RESULTS: Multiple rapid swallows were successfully performed in 89.3% patients and all controls; 225 subjects (56.2 ± 0.9 year, 62.7% female) met study inclusion criteria. Multiple rapid swallows were reproducible in 76.9% patients and 94.4% controls (inhibition phase: 88.0% vs 94.4%, contraction phase 86.7% vs 100%, respectively, p = ns). A gradient of reproducibility was noted, highest in well-developed motor disorders (achalasia spectrum, hypermotility disorders, and aperistalsis, 91.7-100%, p = ns compared to controls); and lower in lesser motor disorders (contraction wave abnormalities, esophageal body hypomotility) or normal studies (62.2-70.8%, p < 0.0001 compared to well-developed motor disorders). Inhibition phase was most discordant in contraction wave abnormalities, while contraction phase was most discordant when studies were designated normal. CONCLUSIONS & INFERENCES: Multiple rapid swallows are highly reproducible, especially in well-developed motor disorders, and complement the standard wet swallow manometry protocol.

Duke Scholars

Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

May 2014

Volume

26

Issue

5

Start / End Page

646 / 653

Location

England

Related Subject Headings

  • Reproducibility of Results
  • Middle Aged
  • Manometry
  • Male
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Female
  • Esophagus
  • Deglutition Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Price, L. H., Li, Y., Patel, A., & Gyawali, C. P. (2014). Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology. Neurogastroenterol Motil, 26(5), 646–653. https://doi.org/10.1111/nmo.12310
Price, L. H., Y. Li, A. Patel, and C Prakash Gyawali. “Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology.Neurogastroenterol Motil 26, no. 5 (May 2014): 646–53. https://doi.org/10.1111/nmo.12310.
Price, L. H., et al. “Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology.Neurogastroenterol Motil, vol. 26, no. 5, May 2014, pp. 646–53. Pubmed, doi:10.1111/nmo.12310.
Journal cover image

Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

May 2014

Volume

26

Issue

5

Start / End Page

646 / 653

Location

England

Related Subject Headings

  • Reproducibility of Results
  • Middle Aged
  • Manometry
  • Male
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Female
  • Esophagus
  • Deglutition Disorders