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

Abstract

BackgroundIt has been suggested that multiple rapid swallowing should be added to oesophageal manometry. AimTo prospectively evaluate whether 10 and 200mL multiple rapid swallowing provide different information concerning motor function. Methods30 consecutive patients with oesophageal symptoms, 13 achalasia patients after successful pneumatic dilation and 19 healthy subjects performed eight 5mL single swallows, two 10mL and one 200mL multiple rapid swallowing. ResultsAlmost all of the healthy subjects and two-thirds of the patients with oesophageal symptoms showed motor inhibition during both 10 and 200mL multiple rapid swallowing. The oesophago-gastric pressure gradient was significantly higher during 200mL 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 10mL than after 200mL multiple rapid swallowing in the healthy subjects and the patients (p<0.05). ConclusionMotor inhibition could be similarly evaluated by means of 10 and 200mL multiple rapid swallowing; 10mL evaluated the after-contraction, whereas 200mL multiple rapid swallowing was more valuable in identifying increased resistance to outflow.