NORMAL VALUES OF ESOPHAGEAL HIGH-RESOLUTION MANOMETRY: A BRAZILIAN MULTICENTER STUDY.

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Diagnostic Technology

Background:

• High-resolution manometry (HRM) is crucial for esophageal diagnostics, but varying catheter systems yield different data.
• Existing Chicago Classification (CC) guidelines lack normative data for the prevalent 24-channel water-perfused HRM system in Brazil.
• This gap hinders accurate interpretation of esophageal pressure measurements.

Purpose of the Study:

• To establish normative esophageal manometry values using a 24-channel water-perfused HRM system.
• To define these values in healthy volunteers in a supine posture.
• To align with Chicago Classification 3.0 parameters.

Main Methods:

• Esophageal HRM was performed on 92 healthy volunteers without GI symptoms or motility-affecting medications.
• Standardized protocols and Alacer software were used for data collection and analysis.
• Normative values were determined using median, range, and 5th/95th percentiles for key metrics.

Main Results:

• Normative values were established: integrated relaxation pressure (IRP) <16 mmHg, distal contractile integral (DCI) 708-4111 mmHg.cm.s, and distal latency (DL) <6 s.
• Peristaltic break size was >4 cm, and the esophagogastric junction contractile integral (EGJ-CI) range was 21.7-86.9 mmHg.cm.s.
• Higher IRP and DL were observed compared to CC 3.0.

Conclusions:

• This study provides the first normative data for the 24-channel water-perfused HRM system in the supine position.
• The data suggest a need to revise CC 3.0 cutoffs for IRP and DL with this system.
• Further research is recommended to validate these findings and their clinical implications for motility disorders.