The motility of esophageal sphincters during liquid and solid bolus swallows: a multicenter normative value study of high-resolution manometry in China.
BACKGROUND
It is gradually accepted that solid bolus swallow needs to be added to the procedure of manometry. The motility differences in the upper esophageal sphincter (UES) and lower esophageal sphincter (LES) were not well described. Sierra Scientific Instruments solid-state high-resolution manometry (HRM) system, the most popular HRM system in China, lacks the Chinese normative values for both liquid and solid bolus swallow parameters.


METHODS
The esophageal HRM data of 88 healthy volunteers were analyzed. The parameters of both sphincters in resting stage were summarized and those during solid and liquid swallows were compared.


RESULTS
Normative HRM values of sphincter parameters in solid and liquid bolus swallows in China were established. The UES residual pressure of solid bolus swallows was lower than that of liquid bolus (0.3±5.5 mm Hg vs 4.8±5.9 mm Hg, P=.000). The time parameters of UES relaxation between two types of bolus swallows were similar. In solid bolus swallows, the intrabolus pressure (IBP) (13.8±5.1 mm Hg vs 10.9±5.7 mm Hg, P=.000) and LES relaxation time (11.0±2.1 seconds vs 8.7±1.3 seconds, P=.000) were higher. The 4-second integrated relaxation pressure between both bolus swallows was similar.


CONCLUSIONS
The function of the UES and LES between solid and liquid bolus swallows is different. Chinese HRM parameters are different from the Chicago Classification (http://www.chictr.org.cn, Number ChiCTR-EOC-15007147).
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
X-L
XL
Xiang
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
A
A
Wang
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
L
L
Tu
Division of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
M-Y
MY
Ke
Division of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.
Y-S
YS
Yang
Division of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
B
B
Jiang
Division of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
L
L
Lin
Division of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China.
N
N
Dai
Division of Gastroenterology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
S-S
SS
Zhang
Division of Gastroenterology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
L
L
Tao
Division of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin, China.
H
H
Xu
Division of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
X-M
XM
Liang
Division of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
X-C
XC
Fang
Division of Gastroenterology, Peking University Third Hospital, Beijing, China.
Z-W
ZW
Xia
State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Disease, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
X
X
Wang
Division of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
J-N
JN
Wu
Division of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
M-F
MF
Wang
Division of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
H-J
HJ
Zhang
Division of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China.
Y-F
YF
Fang
Division of Gastroenterology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
C
C
Shen
Division of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin, China.
J
J
Wang
Division of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.
L-H
LH
Peng
Division of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
W-Y
WY
Li
Division of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Z-F
ZF
Wang
Division of Gastroenterology, Peking University Third Hospital, Beijing, China.
K
K
Wang
State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Disease, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
N
N
Liu
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
X-H
XH
Hou
D000328:Adult; D002681:China / Q000453:epidemiology; D003679:Deglutition / Q000502:physiology*; D004326:Drinking / Q000502:physiology*; D004435:Eating / Q000502:physiology*; D049630:Esophageal Sphincter, Lower / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged

HRM
; bolus type; esophageal sphincters; normal values