title: Normal values of esophageal pressure responses to a rapid drink challenge test in healthy subjects: results of a multicenter study.
abstract: BACKGROUND
  Multiple water swallow is increasingly used as a complementary challenge test in patients undergoing high-resolution manometry (HRM). Our aim was to establish the range of normal pressure responses during the rapid drink challenge test in a large population of healthy subjects.
  
  
  METHODS
  Pressure responses to a rapid drink challenge test (100 or 200 mL of water) were prospectively analyzed in 105 healthy subjects studied in nine different hospitals from different countries. Esophageal motility was assessed in all subjects by solid-state HRM. In 18 subjects, bolus transit was analyzed using concomitant intraluminal impedance monitoring.
  
  
  RESULTS
  A virtually complete inhibition of pressure activity was observed during multiple swallow: Esophageal body pressure was above 20 mm Hg during 1 (0-8) % and above 30 mm Hg during 1 (0-5) % of the swallow period, and the pressure gradient across the esophagogastric junction was low (-1 (-7 to 4) mm Hg). At the end of multiple swallow, a postswallow contraction was evidenced in only 50% of subjects, whereas the remaining 50% had non-transmitted contractions. Bolus clearance was completed after 7 (1-30) s after the last swallow, as evidenced by multichannel intraluminal impedance.
  
  
  CONCLUSIONS
  The range of normal pressure responses to a rapid drink challenge test in health has been established in a large multicenter study. Main responses are a virtually complete inhibition of esophageal pressures with a low-pressure gradient across esophagogastric junction. This data would allow the correct differentiation between normal and disease when using this test.
authors.affiliation: Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Marin
authors.affiliation: Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago de Chile, Chile.
authors.forename: D
authors.initials: D
authors.lastname: Cisternas
authors.affiliation: University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Abrao
authors.affiliation: University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Lemme
authors.affiliation: Hospital Universitario - Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Bilder
authors.affiliation: Hospital Universitario - Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Ditaranto
authors.affiliation: Axxis Hospital, Quito, Ecuador.
authors.forename: R
authors.initials: R
authors.lastname: Coello
authors.affiliation: San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: A
authors.initials: A
authors.lastname: Hani
authors.affiliation: San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: A M
authors.initials: AM
authors.lastname: Leguizamo
authors.affiliation: Veracruzana University, Veracruz, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Meixueiro
authors.affiliation: Veracruzana University, Veracruz, Mexico.
authors.forename: J
authors.initials: J
authors.lastname: Remes-Troche
authors.affiliation: Veracruzana University, Veracruz, Mexico.
authors.forename: M A
authors.initials: MA
authors.lastname: Zavala
authors.affiliation: Clínic San Carlos Hospital, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ruiz de León
authors.affiliation: Clínic San Carlos Hospital, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Perez de la Serna
authors.affiliation: Salvador Zubirán Institute, Ciudad de Mexico, Mexico.
authors.forename: M A
authors.initials: MA
authors.lastname: Valdovinos
authors.affiliation: Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Serra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003679:Deglutition; D004326:Drinking; D017097:Electric Impedance; D004947:Esophagus / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
keywords: esophageal bolus clearance; high-resolution esophageal manometry; high-resolution impedance manometry; multiple water swallow