Dynamic response criteria for fluid-filled esophageal manometers.

Abstract

Accurate esophageal manometry depends on a manometer capable of faithfully reproducing the pressure fluctuations within the esophageal lumen. The rational selection of an esophageal manometer adequate to record esophageal peristaltic activity depends on a knowledge of the frequencies represented in the significant features of the esophageal waveform. Information regarding the predominant frequencies of the esophageal waveforms may be obtained by recording simultaneous pressure measurements at the same location in the esophagus with two manometers which respond differently to pressure fluctuations. A system of two infused fluid-filled manometers was constructed which in in vitro testing responded in a significantly different manner to sinusoidal pressure fluctuations above one hertz. Peristaltic pressure recordings in vivo in the distal third of the normal human esophageal body revealed no significant difference in the tracings obtained from the two manometers, indicating that only pressure fluctuations below one hertz were significant in determining the shape of normal distal esophageal peristaltic waveforms. Similar methodology may be applied for determining the predominant frequencies in other parts of the normal esophagus and for determining the predominant frequencies in esophageal motility disorders.