The motility of esophageal sphincters during liquid and solid bolus swallows: a multicenter normative value study of high‐resolution manometry in China

Xiang, Xuelian; Wang, A.; Tu, Lei; Yang, Yunsheng; Jiang, Bo; Li, Lin; Dai, Ning; Zhang, S.-S.; Lin, Ting‐Tse; Xu, Hong; Liang, Xiaohu; Fang, Xiucai; Xia, Zhiwei; Wang, X.; Wu, Jianuan; Wang, M.-F.; Zhang, H.-J.; Fang, Yanfei; Shen, Chen; Wang, J.; Peng, Lihua; Li, W.-Y.; Wang, Z.-F.; Wang, K.; Liu, N.; Hou, Xiaohua

doi:10.1111/nmo.12914

Cited by 14 publications

(27 citation statements)

References 21 publications

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“…Normal values of esophageal body parameters of both liquid and solid bolus swallows were demonstrated in Table . In bread swallows, CFV was slower, DL was longer, and DCI was higher than water swallows (all P < 0.001), but 4s IRP was similar as water swallows ( P = 0.169) (Figure ).…”

Section: Resultsmentioning

confidence: 90%

“…High‐resolution esophageal manometry (HREM) is more accurate compared with conventional manometry for the assessment of esophageal motility . Using HREM, we had approved the motility of esophagogastric junction (EGJ) was different between solid and liquid bolus swallows . With regard to the esophageal body motility of solid bolus swallow, the results from two different studies with HREM were controversial.…”

Section: Introductionmentioning

confidence: 99%

“…The third study used water‐perfusion HREM with impedance, and it only tested water swallows . We had used Sierra Scientific Instruments (SSI) solid‐state HRM system, the popularly used HREM system in China, provided the Chinese normative values of EGJ parameters for both solid and liquid bolus swallows . Another study from our laboratory which recruited 24 asymptomatic individuals provided some information about the esophageal motility in both water and bread swallows .…”

Section: Introductionmentioning

confidence: 99%

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The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

Xiang

Wang

et al. 2019

Neurogastroenterology Motil

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Background The results of the esophageal body motility differences between liquid and solid swallows from high‐resolution manometry (HRM) studies are not consistent. The information of the frequency of ineffective liquid and solid bolus swallows in healthy individuals during HRM procedure is limited. The normative values of the HRM parameters of both liquid and solid swallows for Chinese population are lacking. Methods The esophageal HRM data of 101 healthy volunteers from multicenters in China were analyzed. The values of the HRM parameters were summarized and compared between liquid and solid swallows. The frequencies of ineffective liquid and solid swallows were summarized. Results Esophagus contracted stronger and slower in solid bolus swallows than water swallows with HREM. Ineffective water swallow (DCI < 450 mm Hg.s.cm) and ineffective bread swallow (DCI < 800 mm Hg.s.cm) were frequently seen in asymptomatic individuals. The adding of bread swallows to the HREM procedure might cause diagnostic change in about 15.8% (16/101) of the asymptomatic individuals. Conclusions The vigor and velocity of the esophageal peristalsis between liquid and solid bolus swallows are different. Ineffective water and solid bolus swallows are not rare. Adding solid bolus swallows brings diagnostic change, and it may be needed routinely for the HRM procedure.

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Section: Resultsmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

Xiang

Wang

et al. 2019

Neurogastroenterology Motil

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“…It was performed by using a high‐resolution solid‐state (Sierra Scientific Instruments, SSI) or a water perfusion catheter (Solar GI HRM, Medical Measurement System, MMS). Details of the procedure methods had been described previously . Esophageal pressures at rest and ten 5ml water swallows were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…Low lower esophageal sphincter pressure (LESP) at rest was defined when it was <10 mm Hg in both systems. Ten mm Hg as threshold was based on the data from the literatures . EGJ contractile integral (EGJ‐CI) was calculated as described by Nicodème et al Ineffective swallow was defined as the swallow in which the distal contractile integral (DCI) was <450 mm Hg/s/cm, and if the frequency of the ineffective swallow reached 50% out of 10 water swallows, ineffective esophageal motility (IEM) was diagnosed …”

Section: Methodsmentioning

confidence: 99%

The importance of pH reflux monitoring test for the management of low‐grade esophagitis in Chinese patients

Qiu

Zhang

Bai

et al. 2019

Neurogastroenterology Motil

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Background and aims Low‐grade esophagitis (grade A and B) are no longer believed as confirmatory evidence of gastroesophageal reflux disease, but there were no data about the association of low‐grade esophagitis with pathological acid reflux (PAR) in China. This study aimed to summarize the proportion of PAR in the patients with low‐grade esophagitis and to explore the differential factors between low‐grade esophagitis patients with and without PAR. Methods Database of the patients accepted 24‐hour pH monitoring in the motility laboratory of a tertiary center was retrospectively searched, and the patients were diagnosed as low‐grade esophagitis before the procedure was recruited. The demographics, symptoms and high‐resolution manometry and pH monitoring parameters were compared between the patients with pathological and physiological acid reflux and between patients with grade A and B esophagitis. Results About 24% of grade A and 55% of grade B esophagitis patients had pathological acid reflux. The demographics, symptoms, and almost all high‐resolution manometry findings were similar in patients with pathological and physiological acid reflux. About two‐thirds of the participants with physiological acid reflux reported symptom improvement after PPI administration. All participants with PPI‐resistant symptoms were with physiological acid reflux. Conclusion The proportion of PAR in low‐grade esophagitis is not high. For patients with low‐grade esophagitis in China, especially the patients with grade A esophagitis, regardless of symptom change, reflux monitoring is possibly needed for the patients whose esophageal mucosa break is not improved after 8 weeks of PPI treatment.

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Effect of Topical Nasal Anesthetic on Comfort and Swallowing in High‐Resolution Impedance Manometry

et al. 2022

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Objectives/Hypothesis: Use of topical nasal anesthetic (TNA) is common in high-resolution impedance manometry (HRIM). This study investigated the effect of TNA on swallowing and procedure tolerability during HRIM with a 4.2-mm catheter, a more commonly used catheter size with impedance capabilities.Study Design: Randomised experimental study with blinding of participants. Methods: Twenty healthy participants (mean age = 33 years, 16 female) were randomized to undergo HRIM using the ManoScan™ ESO Z 4.2-mm catheter twice, 1 week apart, under two conditions: with TNA (viscous lidocaine) and with placebo. Analyses included esophageal data of three saliva, three saline (5 mL), and three bread swallows (2 cm Â 2 cm) performed while reclined 45 , and pharyngeal data under the same conditions while seated upright. Pharyngeal and upper esophageal sphincter (UES) HRIM parameters were analyzed using the Swallow Gateway analysis platform. Visual analogue scale (VAS) scores rating procedural comfort were analyzed.Results: There were no significant physiological differences in pharyngeal and UES parameters between conditions. There were also no significant differences in VAS scores under placebo (mean = 54.8, standard deviation (SD) = 19.3) and TNA (mean = 60.0, SD = 21.9) (t[19] = À0.9, P = .4) conditions; however, there was a significant difference in the first versus second session (t[19]) = 5.1, P < .05).Conclusions: TNA did not improve comfort, but it also did not significantly affect swallowing behavior. There was, however, a practice effect regardless of TNA use with improved tolerance of the 4.2-mm catheter and likely more natural swallowing behavior during the second session of HRIM.

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The motility of esophageal sphincters during liquid and solid bolus swallows: a multicenter normative value study of high‐resolution manometry in China

Abstract: The function of the UES and LES between solid and liquid bolus swallows is different. Chinese HRM parameters are different from the Chicago Classification (http://www.chictr.org.cn, Number ChiCTR-EOC-15007147).

Cited by 14 publications

References 21 publications

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

The importance of pH reflux monitoring test for the management of low‐grade esophagitis in Chinese patients

Effect of Topical Nasal Anesthetic on Comfort and Swallowing in High‐Resolution Impedance Manometry

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