Usefulness of low- and high-volume multiple rapid swallowing during high-resolution manometry. 2015

Alessandra Elvevi, and Aurelio Mauro, and Delia Pugliese, and Ivana Bravi, and Andrea Tenca, and Dario Consonni, and Dario Conte, and Roberto Penagini
Gastrointestinal and Digestive Endoscopy Unit, Università degli Studi and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

BACKGROUND It has been suggested that multiple rapid swallowing should be added to oesophageal manometry. OBJECTIVE To prospectively evaluate whether 10 and 200 mL multiple rapid swallowing provide different information concerning motor function. METHODS 30 consecutive patients with oesophageal symptoms, 13 achalasia patients after successful pneumatic dilation and 19 healthy subjects performed eight 5 mL single swallows, two 10 mL and one 200 mL multiple rapid swallowing. RESULTS Almost all of the healthy subjects and two-thirds of the patients with oesophageal symptoms showed motor inhibition during both 10 and 200 mL multiple rapid swallowing. The oesophago-gastric pressure gradient was significantly higher during 200 mL multiple rapid swallowing within each group (p < 0.01), and significantly higher in the achalasia patients than in the other two groups (p < 0.0001). Presence of a contraction and increased contraction strength in comparison with single swallows were both more frequent after 10 mL than after 200 mL multiple rapid swallowing in the healthy subjects and the patients (p<0.05). CONCLUSIONS Motor inhibition could be similarly evaluated by means of 10 and 200 mL multiple rapid swallowing; 10 mL evaluated the after-contraction, whereas 200 mL multiple rapid swallowing was more valuable in identifying increased resistance to outflow.

UI MeSH Term Description Entries
D008297 Male Males
D008365 Manometry Measurement of the pressure or tension of liquids or gases with a manometer. Tonometry,Manometries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003679 Deglutition The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat. Swallowing,Deglutitions,Swallowings
D004106 Dilatation The act of dilating. Dilation,Dilatations,Dilations
D004931 Esophageal Achalasia A motility disorder of the ESOPHAGUS in which the LOWER ESOPHAGEAL SPHINCTER (near the CARDIA) fails to relax resulting in functional obstruction of the esophagus, and DYSPHAGIA. Achalasia is characterized by a grossly contorted and dilated esophagus (megaesophagus). Achalasia, Esophageal,Cardiospasm,Megaesophagus,Achalasia,Achalasias,Achalasias, Esophageal,Cardiospasms,Esophageal Achalasias
D004935 Esophageal Diseases Pathological processes in the ESOPHAGUS. Disease, Esophageal,Diseases, Esophageal,Esophageal Disease
D004947 Esophagus The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
D005260 Female Females

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