Impedance-Manometry with Viscous Test Solution Increases Detection of Esophageal Function Defects

Abstract

Purpose: Multichannel intraluminal impedance and manometry (MII-EM) is performed using ten 5 ml swallows each of both liquid and viscous solution. The manometric diagnosis is based solely on results from the 10 liquid swallows. It was recently demonstrated that manometric diagnoses based on 10 liquid and 10 viscous swallows combined were similar to those with 10 liquid swallows alone. The aim of the study was to compare esophageal function evaluated with 10 liquid versus 10 viscous swallows using combined MII-EM in patients with various symptoms. Methods: We analyzed consecutive MII-EM studies performed in 300 patients (211 women, mean age 54.5 yrs). The manometric diagnoses were separated into normal manometry and abnormal manometry. MII findings included number of complete and incomplete transits and total bolus transit time. Results: The results are summarized in Tables 1–2.Table: Manometric and impedance diagnoses for liquid and viscous swallows.Table: Mean characteristics of liquid and viscous swallows.Manometric diagnosis for liquid and viscous was consistent in 231 (77%) and inconsistent in 69 (23%) patients (p < 0.0001). Among these 69 patients, 48 had abnormal viscous and normal liquid manometry, 17 had normal viscous and abnormal liquid manometry and 4 had different abnormalities in liquid and viscous manometry (p < 0.0001). Impedance diagnosis for viscous and liquid was consistent in 238 (79.3%) patients and inconsistent in 62 (20.7%) patients (p < 0.0001). Conclusions: Our results indicate that viscous solution detects more manometric abnormalities than liquid solution. Impedance diagnosis has greater similarity for both liquid and viscous solutions.