Esophageal Dysmotility in Patients with Non-obstructive Dysphagia: Studies Using Combined Manometry and Impedance

Abstract

This study aimed to assess and characterize esophageal motility and bolus transport in patients with non-obstructive dysphagia (NOD). Combined esophageal manometry and impedance was performed in 18 consecutive NOD patients and 14 healthy controls. Esophageal peristalsis was abnormal if the amplitude of distal esophageal contractions was less than 30 mmHg or simultaneous contractions occurred. Bolus transit was abnormal if bolus exit was not found at one or more of the measuring sites. The prevalence of normal peristalsis was greater in healthy controls than in NOD patients during liquid (91% vs. 51%, P=0.001) and viscous swallows (83% vs. 49%, P=0.001). The prevalence of complete bolus transit was lower in NOD patients compared to healthy controls during liquid (73% vs. 95%, P=0.001) and viscous swallows (57% vs. 85%, P=0.001). Abnormal liquid bolus transit was found in 40% of patients with normal motility (manometry) and 38% of patients with abnormal motility (manometry), whereas abnormal viscous bolus transit was observed in 38% of patients with normal motility (manometry) and 70% of patients with abnormal motility (manometry). Multiple intraluminal impedance helps identify bolus transit abnormalities not detected by conventional manometry. Combined multiple intraluminal impedance and esophageal manometry is clinically useful for detecting esophageal dysmotility in patients with NOD.