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Updated: Aug 22, 2025

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Can the marshmallow esophagram replace high-resolution manometry as an appropriate screening for esophageal motility
Chloe W Caudell1, Ethan P Covil1, John W Gilpin1
1University of South Carolina School of Medicine Greenville, Prisma Health Upstate, USA.
Backgound:
The purpose of our study was to evaluate the use of minimally invasive Marshmallow Swallow Study (MSS) as a preoperative screening technique for patients and correlate marshmallow results with High Resolution Manometry (HRM) results and post-operative dysphagia following antireflux surgery.
Methods:
A retrospective electronic chart review of data on 61 adult patients undergoing MSS was completed. Patients were included if they completed the MSS as well as: HRM and/or antireflux surgery.
Results:
Sixty-one patients completed MSS. Of the 37 patients that completed HRM, 27 had abnormal results. 23 of these 27 patients who had abnormal results also failed MSS. The NPV for a failure on the MSS and abnormal HRM results is 0.767(p-value = 0.360). The PPV for a pass on the MSS and no post-operative dysphagia is 0.833 (p-value = 0.656).
Conclusions:
MSS is an effective screening tool for ruling out major esophageal motility disorders and can prevent need for invasive HRM.
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