Gender-Related Variation in Lower Esophageal Sphincter Pressure and Esophageal Body Function

Abstract

Purpose: Esophageal manometry (EM) is the gold standard examination for diagnosis of esophageal motor disorders. Gender-related variation is a well recognized normal physiological phenomenon. To date, there are very limited gender specific data relevant to EM measurements. The aim of this study was to obtain values of EM in healthy males and females to determine if gender variation exists in normal esophageal motor function. Methods: Healthy men and women were recruited from the Jacksonville, FLmetropolitan area. Exclusion criteria were symptoms suggestive of esophageal disease, medication use or concurrent illness that could affect EM. All underwent EM using a solid-state system with wet swallows (Polygram Net, Medtronic Inc., Minneapolis, MN). Resting lower esophageal sphincter pressure, percent peristaltic contractions, distal esophageal body contraction velocity, distal esophageal body contraction amplitude and distal esophageal body contraction duration were measured at end-expiration. Results: Sixty-three males and 66 females were enrolled. All subjects completed EM without difficulty. The male group was significantly younger than the female group (M 31.4 ± 10.6 years old, F 35.2 ± 10; P < 0.04). Resting lower esophageal sphincter pressure (RELSP), distal esophageal contraction duration (DEBCD) and distal esophageal body contraction amplitude (DEBCA) were significantly higher in females compared to males while distal esophageal body contraction velocity (DEBCV) was significantly lower in females than males (P < 0.05, Table). There were no differences seen in lower esophageal sphincter length (LESL) and percent peristaltic contractions (%PC). Conclusion: Significant gender-related differences exist in EM findings. These differences underscore the need for gender specific reference values for EM studies to allow for the accurate diagnosis of esophageal motility disorders.Table: Gender specific esophageal motility parameters