title: High-resolution impedance manometry parameters enhance the esophageal motility evaluation in non-obstructive dysphagia patients without a major Chicago Classification motility disorder.
abstract: BACKGROUND
  High-resolution impedance manometry (HRIM) allows evaluation of esophageal bolus retention, flow, and pressurization. We aimed to perform a collaborative analysis of HRIM metrics to evaluate patients with non-obstructive dysphagia.
  
  
  METHODS
  Fourteen asymptomatic controls (58% female; ages 20-50) and 41 patients (63% female; ages 24-82), 18 evaluated for dysphagia and 23 for reflux (non-dysphagia patients), with esophageal motility diagnoses of normal motility or ineffective esophageal motility, were evaluated with HRIM and a global dysphagia symptom score (Brief Esophageal Dysphagia Questionnaire). HRIM was analyzed to assess Chicago Classification metrics, automated pressure-flow metrics, the esophageal impedance integral (EII) ratio, and the bolus flow time (BFT).
  
  
  RESULTS
  Significant symptom-metric correlations were detected only with basal EGJ pressure, EII ratio, and BFT. The EII ratio, BFT, and impedance ratio differed between controls and dysphagia patients, while the EII ratio in the upright position was the only measure that differentiated dysphagia from non-dysphagia patients.
  
  
  CONCLUSIONS
  The EII ratio and BFT appear to offer an improved diagnostic evaluation in patients with non-obstructive dysphagia without a major esophageal motility disorder. Bolus retention as measured with the EII ratio appears to carry the strongest association with dysphagia, and thus may aid in the characterization of symptomatic patients with otherwise normal manometry.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Carlson
authors.affiliation: Department of Human Physiology, School of Medicine, Flinders University, Bedford Park, SA, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Omari
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Department of Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium.|Translational Research Center for Gastrointestinal Diseases (TARGID), University of Leuven, Leuven, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Starkey
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Kahrilas
authors.affiliation: Translational Research Center for Gastrointestinal Diseases (TARGID), University of Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Tack
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Pandolfino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D017097:Electric Impedance; D015154:Esophageal Motility Disorders / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: dysphagia; esophageal motility; high-resolution manometry; impedance