Solid bolus swallows during high-resolution manometry complement multiple rapid swallows in predicting symptoms...

Area of Science:

• Gastroenterology
• Esophageal Physiology
• High-Resolution Manometry (HRM)

Background:

• Solid bolus swallows (SBS) and multiple rapid swallows (MRS) are used to assess esophageal peristalsis via high-resolution manometry (HRM).
• The utility of contraction reserve (CR) following SBS (SBS-CR) in comparison to MRS (MRS-CR) remains unclear.

Purpose of the Study:

• To investigate if SBS-CR provides similar information to MRS-CR.
• To evaluate the correlation between SBS-CR and MRS-CR in healthy volunteers and patients undergoing anti-reflux surgery (ARS).
• To determine the predictive value of MRS-CR and SBS-CR for post-ARS symptom burden.

Main Methods:

• Clinical and HRM data from 96 patients undergoing ARS and 18 healthy volunteers were analyzed.
• Distal contractile integral (DCI) from single, MRS, and SBS swallows were compared to determine contraction reserve (CR).
• Patient symptoms before and after ARS were assessed using Likert scales.

Main Results:

• Contraction reserve concordance between MRS and SBS varied across different esophageal motility patterns.
• Correlation between MRS DCI and SBS DCI was highest in patients with ineffective esophageal motility (IEM).
• Absence of both MRS-CR and SBS-CR was associated with higher post-ARS symptom burden, particularly in patients with esophageal hypomotility.

Conclusions:

• MRS and SBS are complementary methods for assessing esophageal function.
• Both MRS-CR and SBS-CR are valuable in predicting post-ARS symptom burden.
• These findings highlight the importance of evaluating contraction reserve in patients undergoing ARS.