A comparison of esophageal motility in response to bread swallows and water swallows.

Studies of esophageal manometry during eating have demonstrated abnormal motility in patients with dysphagia in whom standard water-swallow manometry was normal. However, there have been few concurrent motility studies making a direct comparison of food swallows with water swallows. This paper presents the results of such a study in 20 healthy volunteers. A comparison of bread swallows with water swallows revealed that both peristaltic amplitude in the proximal esophagus and peristaltic duration throughout the esophagus were significantly increased (p < 0.05). Peristaltic propagation velocity was significantly decreased in the proximal and mid-esophagus (p < 0.05). Percentages of nonconducted and nonperistaltic contractions were significantly increased (p < 0.05-0.001) during bread-swallow manometry. Therefore, the response of the normal esophagus to food has been shown to be different from its response to water swallows. In particular, the high percentage of nonpropagated swallows in normal subjects when eating indicates that the results of food manometry in patients with dysphagia must include wider limits of normality.