Utilizing intrabolus pressure and esophagogastric junction pressure to predict transit in patients with Dysphagia.
OBJECTIVE
High-resolution manometry (HRM), with a greatly increased number of recording sites and decreased spacing between sites, allows evaluation of the dynamic simultaneous relationship between intrabolus pressure (IBP) and esophagogastric junction (EGJ) relaxation pressure. We hypothesized that bolus transit may occur when IBP overcomes integrated relaxation pressure (IRP) and analyzed the relationships between peristalsis pattern and the discrepancy between IBP and IRP in patients with dysphagia.


METHODS
Twenty-two dysphagia patients with normal EGJ relaxation were examined with a 36-channel HRM assembly. Each of the 10 examinations was performed with 20 and 30 mmHg pressure topography isobaric contours, and findings were categorized based on the Chicago classification. We analyzed the relationships between peristalsis pattern and the discrepancy between IBP and IRP.


RESULTS
Twenty-two patients were classified by the Chicago classification: 1 patient with normal EGJ relaxation and normal peristalsis, 8 patients with intermittent hypotensive peristalsis and 13 patients with frequent hypotensive peristalsis. A total of 220 individual swallows were analyzed. There were no statistically significant relationships between peristalsis pattern and the discrepancy between IBP and IRP on the 20 or 30 mmHg isobaric contours.


CONCLUSIONS
Peristalsis pattern was not associated with bolus transit in patients with dysphagia. However, further controlled studies are needed to evaluate the relationship between bolus transit and peristalsis pattern using HRM with impedance.
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Su Hyeon
SH
Jeong
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Moo In
MI
Park
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Hyung Hun
HH
Kim
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Seun Ja
SJ
Park
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Won
W
Moon
Esophageal motility disorder; Manometry; Peristalsis