Utility of esophageal impedance in identifying dysmotility in patients with erosive esophagitis.

SUMMARY: This study was intended to assess the utility of combined multiple intraluminal impedance and esophageal manometry (MII-EM) in evaluating reflux patients and in identifying those with esophageal dysmotility. Thirteen controls and 20 patients with gastroesophageal reflux disease (GERD) underwent combined MII-EM with a catheter containing four impedance-measuring segments and four solid-state pressure transducers. Each subject received 10 liquid and 10 viscous boluses to be swallowed. Distal esophageal contraction amplitude was significantly lower in GERD patients than in controls for viscous swallows (58.3 +/- 7.3 mmHg versus 82.4 +/- 4.1 mmHg, P = 0.005). Total bolus transit time was significantly slower in GERD patients than in controls for liquid swallows (P = 0.035). The percentages of complete bolus transit were significantly lower in GERD patients compared with controls (all P = 0.005). Half of GERD patients with normal EM still had abnormal bolus transit while three-quarters of those with abnormal EM had abnormal bolus transit. MII helps identify bolus transit abnormalities not detected by conventional manometry. Combined MII-EM is clinically useful for detecting esophageal dysmotility in patients with erosive esophagitis.