TITLE:
Semi-Solid and Solid Bolus Swallows in High-Resolution Oesophageal Manometry for the Detection of Motility Disorders
AUTHORS:
Jerry Zhou, Catherine Sykes, Vincent Ho
KEYWORDS:
High-Resolution Manometry, Oesophagus, Motility, Diagnostic Classification, Bolus Type
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.8 No.1,
January
25,
2018
ABSTRACT:
Background/Aims: High-resolution oesophageal manometry utilises water
swallows to evaluate oesophageal function. However, small volumes of water
are not representative of normal eating and as a result often produce normal
manometry studies in patients with dysphagia. This study sets out to establish
optimal diagnostic thresholds for semi-solid solid swallows and evaluate their
ability to uncover motility abnormalities in patients with motility disorders.
Method: Manometry was performed using ten 5-mL single water swallows
followed by two semi-solid and two solid swallows in the upright position.
Normative values for the adjunctive tests were obtained from patient controls
while patients with major motility disorders were used to establish the optimal
diagnostic thresholds. Diagnostic thresholds identified were prospectively
tested in patients with normal water swallows but oesophagus related symptoms
and in those with minor and major motility disorders. Results: Normal
values for semi-solid and solid were determined in patient controls (n = 100).
Development of diagnostic thresholds included 120 patients with major motility
disorders. Optimal diagnostic thresholds identified for oesophagogastric
junction dysfunction in semi-solid and solid swallows (IRP > 15.5 mmHg). Hypercontractilty
and spasm used existing thresholds (>8000 mmHg-s-cm and