Impedance manometry with viscous test solution increases detection of esophageal function defects compared to liquid...

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Diagnostic Testing

Background:

• Multichannel intraluminal impedance and manometry (MII-EM) is a key diagnostic tool for esophageal disorders.
• Current MII-EM protocols primarily rely on liquid swallows for manometric analysis.
• The diagnostic yield of viscous swallows in MII-EM remains underexplored.

Purpose of the Study:

• To compare the diagnostic capabilities of liquid versus viscous swallows in MII-EM.
• To evaluate the consistency of manometric and impedance diagnoses between liquid and viscous solutions.
• To assess esophageal function in patients with diverse symptoms using combined MII-EM.

Main Methods:

• Analysis of consecutive MII-EM studies in 300 patients (211 female, mean age 54.5 years).
• Comparison of manometric diagnoses (normal vs. abnormal) using 10 liquid and 10 viscous swallows.
• Assessment of MII findings including complete/incomplete transits and total bolus transit time.

Main Results:

• Manometric diagnosis consistency was 77% for liquid and 79.3% for viscous solutions.
• Viscous solutions identified significantly more manometric abnormalities (30.3%) than liquid solutions (20%).
• No significant difference in bolus transit abnormalities was observed between liquid (25%) and viscous (28.3%) solutions.

Conclusions:

• Viscous solutions enhance the detection of manometric abnormalities in MII-EM.
• Impedance-based diagnoses demonstrate high consistency between liquid and viscous swallows.
• Utilizing viscous solutions may improve the diagnostic accuracy of MII-EM for esophageal motility disorders.