title: Utility of Esophagram versus High-Resolution Manometry in the Detection of Esophageal Dysmotility.
abstract: This study compared barium esophagram with high-resolution esophageal manometry (HRM) results to determine whether esophagram is an adequate screening examination for esophageal motility disorders, a common cause of dysphagia.
  
  
  
  Case series with chart review.
  
  
  
  Tertiary academic medical center.
  
  
  
  A retrospective review was completed of 281 patients who underwent both HRM and esophagram from March 2012 to June 2014. Inclusion criteria included a specific assessment of the presence or absence of dysmotility on both examinations.
  
  
  
  Eighty-four males and 197 females were included in the study. Average age was 57 years (range, 16-84). Average time between studies was 19 days (range, 0-90). Motility was judged to be normal in 40.2% (113 of 281) of esophagrams and 46.6% (131 of 281) of HRM studies. However, disagreement between the study findings was significant (P = .04). The sensitivity of esophagram for detecting esophageal dysmotility was 0.69, and specificity was 0.50. The positive and negative predictive values of esophagram for dysmotility were 0.61 and 0.58, respectively.
  
  
  
  Esophagram is useful in the assessment of anatomic abnormalities but is a poor screening examination for the detection of esophageal dysmotility. Patients with suspected esophageal dysphagia should be referred for HRM to evaluate motility disorders and identify potential treatment targets, regardless of esophagram results.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA aorourke@musc.edu.
authors.forename: Ashli K
authors.initials: AK
authors.lastname: O'Rourke
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Andreea
authors.initials: A
authors.lastname: Lazar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Murphy
authors.affiliation: Department of Gastroenterology-Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Donald O
authors.initials: DO
authors.lastname: Castell
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Martin-Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate / Q000008:administration & dosage*; D003287:Contrast Media / Q000008:administration & dosage*; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: esophageal dysmotility; esophageal dysphagia; esophageal manometry; esophagram