Tu1280 – Performing More Than Ten Swallows During High Resolution Esophageal Manometry Does Not Identify Substantially More Cases of Ineffective Esophageal Motility

Abstract Objectives To evaluate the influence of change of diet composition on esophageal manometry metrics. Methods The data of 43 NERD patients with low (<20 g/day) baseline dietary fiber intake served as a source data. These patients were examined with the use of standard food frequency questionnaire and high-resolution esophageal manometry. Thirty of them received psyllium 5.0 g TID 10 days in addition of their usual diet within registered clinical trial (NCT01882088). The other 13 were found in the database by diagnosis; their data were eligible in case of the presence of repeated high-resolution esophageal manometry examination and dietary assessments at the same time point and if no significant change in diet composition was revealed. The changes were assessed in accordance to Chicago classification 3.0. Non-parametric statistics (Wilcoxon matched pairs test, Mann-Whitney U-test) were used to assess the change in HRM metrics in these groups. Results In those who received psyllium, significant increase of minimal lower esophageal resting pressure at rest and after 10 water swallows was registered: 5.41 ± 10.1 vs 11.3 ± 9.4 mm Hg, P = 0.023 and 14.1 ± 8.0 vs 14.9 ± 6.4 mm Hg, P = 0.008, accordingly. No significant difference was found in the group with no change of diet composition by these parameters. At baseline, ineffective esophageal motility was found in 46.7% patients of the study group and 53.8% in the control group (P = 0.7). Esophageal motility became normal in 71.4% of those who had IEM initially in the study group after 10 days of treatment, and in 14.3% among the controls (P = 0.0135). This type of peristaltic abnormality was found not changed in 28.6% of the study group and in 85.7% among the control group, P = 0.014. New cases of ineffective esophageal motility revealed in 12.5% of the study group and 16.7% among the controls (P = 0.8) Conclusions Change of diet composition by additional quantity of psyllium may result in the improvement of esophageal motility. Funding Sources Federal Research Center of Nutrition and Biotechnology.

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Normative Values for Esophageal Motility Assessed in the Physiological Seated Position for 16-Channel Water Perfused High-resolution Esophageal Manometry System and Postural Variations in Healthy Volunteers

Journal of Neurogastroenterology and Motility ◽

10.5056/jnm19082 ◽

2020 ◽

Vol 26 (1) ◽

pp. 61-66 ◽

Cited By ~ 2

Author(s):

Melpakkam Srinivas ◽

Mayank Jain ◽

Piyush Bawane ◽

Venkataraman Jayanthi

Keyword(s):

High Resolution ◽

Healthy Volunteers ◽

Esophageal Motility ◽

Esophageal Manometry ◽

Normative Values ◽

Channel Water

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P173 HIGH-RESOLUTION MANOMETRIC FINDINGS AFTER MAGNETIC SPHINCTER AUGMENTATION

Diseases of the Esophagus ◽

10.1093/dote/doz092.173 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

Carlo Galdino Riva ◽

Stefano Siboni ◽

Veronica Lazzari ◽

Marco Sozzi ◽

Emanuele Asti ◽

...

Keyword(s):

High Resolution ◽

Esophageal Motility ◽

Symptom Relief ◽

Rank Test ◽

Barium Swallow ◽

Upper Gastrointestinal Endoscopy ◽

Magnetic Sphincter Augmentation ◽

Hrql Score ◽

High Resolution Manometry ◽

Ineffective Esophageal Motility

Abstract Aim The aim of this study was to evaluate esophageal motility before and after Magnetic Sphincter Augmentation (MSA) for medically refractory Gastro-Esophageal Reflux Disease (GERD). Background and Methods MSA (LINX® Reflux Management System) is intended for patients with chronic GERD with incomplete symptom relief from proton-pump inhibitors (PPI) and abnormal acid exposure. A prospectively collected database of patients who underwent MSA between 2007 and 2019 was queried. All patients who completed pre- and post-operative high-resolution manometry (HRM) were included in the study. Additional investigations included Health-Related Quality of Life (GERD-HRQL) questionnaire, Functional Outcome Swallowing Scale (FOSS), upper gastrointestinal endoscopy, barium swallow, and 24-96 hours pH-study. Data were analyzed using Wilcoxon signed rank test and McNemar test. Results Forty-five patients met the inclusion criteria. The median follow-up was 10 months (IQR 6). Compared to baseline, there was a statistically significant reduction in PPI use (p=0.000), rate of heartburn (p=0.000), regurgitation (p=0.008), and extra-esophageal symptoms (p=0.000). Only three (6.7%) patients required dietary changes. The GERD-HRQL score significantly improved (p=0.000). There was a significant increase in the Lower Esophageal Sphincter (LES) competency, including LES length (p=0.004) and Esophago-gastric Contractile Integral ((EGJ-CI) (p=0.000). A significant increase in integrated relaxation pressure (IRP) (p=0.000), mean Distal Contractile Integral (DCI) (p=0.008) and intrabolus pressure (p=0.000) was also found. Thirteen (28.9%) patients presented pre-operative Ineffective Esophageal Motility (IEM) and five of them resolved postoperatively. Two patients (4.4%) developed IEM after surgery: both had IRP and DCI values within normal limits, and one of them complained of dysphagia. However, the GERD-HRQL score recovered in both patients. Conclusion MSA was clinically effective in relieving both typical and atypical GERD symptoms. LES competency increased after MSA. EGJ outflow obstruction was uncommon and not associated with symptoms. Finally, ineffective esophageal motility may reverse to normal after MSA.

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