Alessandra Elvevi1, Aurelio Mauro1, Delia Pugliese1, Ivana Bravi1, Andrea Tenca1, Dario Consonni2, Dario Conte1, Roberto Penagini3. 1. Gastrointestinal and Digestive Endoscopy Unit, Università degli Studi and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 2. Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 3. Gastrointestinal and Digestive Endoscopy Unit, Università degli Studi and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: roberto.penagini@unimi.it.
Abstract
BACKGROUND: It has been suggested that multiple rapid swallowing should be added to oesophageal manometry. AIM: To prospectively evaluate whether 10 and 200 mL multiple rapid swallowing provide different information concerning motor function. METHODS: 30 consecutive patients with oesophageal symptoms, 13 achalasia patients after successful pneumatic dilation and 19 healthy subjects performed eight 5 mL single swallows, two 10 mL and one 200 mL multiple rapid swallowing. RESULTS: Almost all of the healthy subjects and two-thirds of the patients with oesophageal symptoms showed motor inhibition during both 10 and 200 mL multiple rapid swallowing. The oesophago-gastric pressure gradient was significantly higher during 200 mL multiple rapid swallowing within each group (p < 0.01), and significantly higher in the achalasia patients than in the other two groups (p < 0.0001). Presence of a contraction and increased contraction strength in comparison with single swallows were both more frequent after 10 mL than after 200 mL multiple rapid swallowing in the healthy subjects and the patients (p<0.05). CONCLUSION: Motor inhibition could be similarly evaluated by means of 10 and 200 mL multiple rapid swallowing; 10 mL evaluated the after-contraction, whereas 200 mL multiple rapid swallowing was more valuable in identifying increased resistance to outflow.
BACKGROUND: It has been suggested that multiple rapid swallowing should be added to oesophageal manometry. AIM: To prospectively evaluate whether 10 and 200 mL multiple rapid swallowing provide different information concerning motor function. METHODS: 30 consecutive patients with oesophageal symptoms, 13 achalasiapatients after successful pneumatic dilation and 19 healthy subjects performed eight 5 mL single swallows, two 10 mL and one 200 mL multiple rapid swallowing. RESULTS: Almost all of the healthy subjects and two-thirds of the patients with oesophageal symptoms showed motor inhibition during both 10 and 200 mL multiple rapid swallowing. The oesophago-gastric pressure gradient was significantly higher during 200 mL multiple rapid swallowing within each group (p < 0.01), and significantly higher in the achalasiapatients than in the other two groups (p < 0.0001). Presence of a contraction and increased contraction strength in comparison with single swallows were both more frequent after 10 mL than after 200 mL multiple rapid swallowing in the healthy subjects and the patients (p<0.05). CONCLUSION: Motor inhibition could be similarly evaluated by means of 10 and 200 mL multiple rapid swallowing; 10 mL evaluated the after-contraction, whereas 200 mL multiple rapid swallowing was more valuable in identifying increased resistance to outflow.
Authors: Rena Yadlapati; Peter J Kahrilas; Mark R Fox; Albert J Bredenoord; C Prakash Gyawali; Sabine Roman; Arash Babaei; Ravinder K Mittal; Nathalie Rommel; Edoardo Savarino; Daniel Sifrim; André Smout; Michael F Vaezi; Frank Zerbib; Junichi Akiyama; Shobna Bhatia; Serhat Bor; Dustin A Carlson; Joan W Chen; Daniel Cisternas; Charles Cock; Enrique Coss-Adame; Nicola de Bortoli; Claudia Defilippi; Ronnie Fass; Uday C Ghoshal; Sutep Gonlachanvit; Albis Hani; Geoffrey S Hebbard; Kee Wook Jung; Philip Katz; David A Katzka; Abraham Khan; Geoffrey Paul Kohn; Adriana Lazarescu; Johannes Lengliner; Sumeet K Mittal; Taher Omari; Moo In Park; Roberto Penagini; Daniel Pohl; Joel E Richter; Jordi Serra; Rami Sweis; Jan Tack; Roger P Tatum; Radu Tutuian; Marcelo F Vela; Reuben K Wong; Justin C Wu; Yinglian Xiao; John E Pandolfino Journal: Neurogastroenterol Motil Date: 2021-01 Impact factor: 3.598
Authors: C Prakash Gyawali; Daniel Sifrim; Dustin A Carlson; Mary Hawn; David A Katzka; John E Pandolfino; Roberto Penagini; Sabine Roman; Edoardo Savarino; Roger Tatum; Michel Vaezi; John O Clarke; George Triadafilopoulos Journal: Neurogastroenterol Motil Date: 2019-04-11 Impact factor: 3.960
Authors: Amanda J Krause; Hui Su; Joseph R Triggs; Claire Beveridge; Alexandra J Baumann; Erica Donnan; John E Pandolfino; Dustin A Carlson Journal: Neurogastroenterol Motil Date: 2020-10-11 Impact factor: 3.598