Solid swallowing versus water swallowing: manometric study of dysphagia

The aim of the study was to investigate whether a soft solid bolus can induce abnormal manometric patterns in patients with dysphagia and normal standard manometry. The study group comprised 12 normal volunteers and 22 patients with dysphagia. Manometry was performed using 10 wet swallows followed by 10 swallows of marshmallow. The results show: (1) in normal subjects the mean contraction amplitude is significantly greater (P less than 0.035) and the velocity of propagation significantly slower (P less than 0.003) for soft solid swallows compared with wet swallows; (2) in normal subjects there are fewer abnormal contractions after soft solid swallows than after wet swallows; (3) in 15 patients, soft solid swallows induced non-peristaltic contractions and/or contractions of extreme amplitude and/or duration that were not observed after wet swallows; (4) in patients, the probability of inducing abnormal contractions after soft solid swallows is significantly greater than after wet swallows (P less than 0.0001). We conclude that soft solid swallowing is useful in the study of patients with dysphagia.