Assessment of bolus transit with intraluminal impedance measurement in patients with esophageal motility disorders.
BACKGROUND
The clinical management of patients with non-obstructive dysphagia is notoriously difficult. Esophageal impedance measurement can be used to measure esophageal bolus transit without the use of radiation exposure to patients. However, validation of measurement of bolus transit with impedance monitoring has only been performed in healthy subjects with normal motility and not in patients with dysphagia and esophageal motility disorders. The aim was, therefore, to investigate the relationship between transit of swallowed liquid boluses in healthy controls and in patients with dysphagia.


METHODS
Twenty healthy volunteers and 20 patients with dysphagia underwent concurrent impedance measurement and videofluoroscopy. Each subject swallowed five liquid barium boluses. The ability of detecting complete or incomplete bolus transit by means of impedance measurement was assessed, using radiographic bolus transit as the gold standard.


RESULTS
Impedance monitoring recognized stasis and transit in 80.5% of the events correctly, with 83.9% of bolus transit being recognized and 77.2% of stasis being recognized correctly. In controls 79.8% of all swallows were scored correctly, whereas in patients 81.3% of all swallows were scored correctly. Depending on the contractility pattern, between 77.0% and 94.3% of the swallows were scored correctly.


CONCLUSIONS
Impedance measurement can be used to assess bolus clearance patterns in healthy subjects, but can also be used to reliably assess bolus transit in patients with dysphagia and motility disorders.
Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands.
A
A
Bogte
Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
A J
AJ
Bredenoord
Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
J
J
Oors
Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands.
P D
PD
Siersema
Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
A J P M
AJ
Smout
D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D017097:Electric Impedance; D004568:Electrodiagnosis / Q000379:methods* / Q000592:standards; D015154:Esophageal Motility Disorders / Q000175:diagnosis*; D005260:Female; D005471:Fluoroscopy; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D001466:Barium Sulfate
bolus transport; dysphagia; esophagus; impedance measurement; stasis; videofluoroscopy