Evaluation of esophageal function in patients with esophageal motor abnormalities using multichannel intraluminal impedance esophageal manometry.
OBJECTIVE
To evaluate the functional aspect of esophageal motility in healthy subjects and in patients who were referred for esophageal function testing using multichannel intraluminal impedance-esophageal manometry (MII-EM), and to assess the clinical utility of MII-EM.


METHODS
From September 2003 to January 2004, we performed the MII-EM on healthy volunteers and all the patients who were referred for esophageal function testing. Each patient received 10 liquid and 10 viscous swallows. We analyzed the results, the impedance and the manometric findings. Some of the subjects had additional ambulatory 24-h pH study performed to diagnose gastroesophageal reflux disease (GERD).


RESULTS
Among 89 studied subjects, the MII-EM findings showed normal esophageal motility in 50 (56.17%), ineffective esophageal motility (IEM) in 17 (19.10%), nutcracker esophagus in 7 (7.86%), achalasia in 4 (4.49%), and scleroderma esophagus in 11 (12.35%) cases. The completeness and the speed of bolus transit were in the order of nutcracker esophagus, normal manometry and IEM. Some of the swallows showing normal manometry and IEM had incomplete transit. In the achalasia and scleroderma esophagus, almost all the swallows had incomplete transit. The body amplitudes were higher for the swallows with complete transit than for the swallows with incomplete transit. There was not a significant difference in the manometric and impedance findings between the subjects with and without GERD.


CONCLUSIONS
MII-EM is a useful tool in assessing the esophageal function in the patients having esophageal motility abnormality. The primary factors influencing the bolus transit are the amplitude of the esophageal body and normal peristalsis.
Cho
Yu Kyung
YK
Department of Internal Medicine, The Catholic University of Korea, Kangnam St. Mary's hospital, Banpodong 505, Seochogu, Seoul, Korea.
Choi
Myung-Gyu
MG
Park
Jae Myung
JM
Oh
Jung Hwan
JH
Paik
Chang Nyol
CN
Lee
Joon Wook
JW
Lee
In Seok
IS
Kim
Sang Woo
SW
Chung
In-Sik
IS
D000328:Adult; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology; D017097:Electric Impedance; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D004947:Esophagus / Q000294:innervation / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods*; D010528:Peristalsis / Q000502:physiology