Assessment of Esophageal Emptying in Patients with Dysphagia: Differences Between High-Resolution Impedance Manometry...

Assessment of esophageal emptying is important in the evaluation of patients with dysphagia. As several modalities can evaluate this, we aimed to compare two tests frequently used for assessing esophageal emptying-highresolution impedance manometry (HRiM) and timed barium esophagram (TBE).

A retrospective study compared the results of HRiM and TBE in patients with dysphagia between 2018 and 2022. Abnormal esophageal clearance was defined as ≥30% swallows with incomplete bolus clearance on HRiM and as residual barium ≥2 cm at 5 minutes on TBE.

77 patients were included in the study (mean age 51.6; 69% female). The most common HRiM diagnoses were normal motility (37.7%), ineffective esophageal motility (28.6%), and achalasia (19.5%). Effective esophageal clearance was noted on HRiM in only 44 subjects (57.1%), while it was seen on TBE in 57 subjects (74.0%)(P=0.027). There was agreement between the studies in 58 subjects (75.3%). Agreement was significantly affected by the HRiM diagnosis with the highest rate (86.7%) among achalasia patients (P=0.032). The only other factor correlated to agreement between the studies was a lack of alcohol use (P=0.048).

According to the parameters used in this study, TBE is more likely to reveal esophageal emptying than HRiM in patients with dysphagia. While there is fair agreement between the results of the two studies, results are especially concordant in achalasia patients suggesting that either study may be useful in evaluating esophageal emptying in that population.