Esophageal Motility in Men and Women Evaluated by High-Resolution Manometry

Abstract

-Background -Esophageal motility has been described in the literature as having differences between men and women. Most of these investigations use the water perfusion method for esophageal manometry. In this investigation the esophageal motility of men and women was compared with high-resolution manometry of the esophagus. Objective -To compare the esophageal motility of men and women with the high-resolution manometry method for esophageal manometry, performed in the sitting position. The hypothesis was that men and women have differences in esophageal motility. Methods -High-resolution manometry was performed in normal volunteers, 10 men [mean age: 37.5 (8.1) years] and 12 women [mean age: 38.7 (7.5) years], in the sitting position and with 10 swallows of a 5 mL bolus of saline, with an interval of at least 30 seconds between consecutive swallows. We evaluated the integrated relaxation pressure of the lower esophageal sphincter, contraction front velocity, distal contraction integral, distal latency, proximal contraction extension, proximal contraction duration >30 mmHg, proximal contraction duration, proximal contraction integral and maximal upper esophageal sphincter pressure. Results -There was no significant difference between men and women in the variables measured. Conclusion -There was no difference in esophageal motility of men and women evaluated by the high resolution manometry method, in the sitting position with swallows of a liquid bolus. HEADINGS -Gastrointestinal motility. Manometry, methods. Sex factors.

The effects of different postures and provocative swallow materials on the normative Chicago 3.0 metrics in a healthy Asian population

“…However, this variation between sexes is not consistent in other literatures 26 . The low IRP‐4 s may be linked to lower LES pressure observed in male patients or may be due to the effect of raised gastroesophageal gradient from obesity because we observed the same effects in obese state, but the exact reason is unknown 25,26 . At this juncture, whether to have different thresholds for men or women is unclear, and neither does Chicago classification v3.0 discriminate between the two, but future larger population‐based studies may be able to address the gender differences and to inform future classifications.…”

“…Besides, a similar increment with viscous swallow was observed with DL, and perhaps, the greater intrabolus pressure from viscous materials causes a delay in distal esophageal clearance 15 . It is worthy to note that although the 95th percentile value of DL reported by the Chicago classification was 7.6 s, 30,31 ours and the European population found that 8.5 s may be an acceptable threshold 26 . Provocative swallows with solids like bread may have been a better challenge than liquid swallows with the intention to unmask underlying motor diseases 3 .…”

“…In addition to age, being male patients also have lower IRP‐4 s compared with female patients, similarly reported by Jung et al 25 . However, this variation between sexes is not consistent in other literatures 26 . The low IRP‐4 s may be linked to lower LES pressure observed in male patients or may be due to the effect of raised gastroesophageal gradient from obesity because we observed the same effects in obese state, but the exact reason is unknown 25,26 .…”

Water Ingestion Dynamics in Patients With Achalasia: Influence of Sex and Age

“…Also, differences in swallowing between men and women is a matter of controversy (17) , and may not be clinically relevant among patients with achalasia. In healthy subjects, gender does not seem to influence esophageal motility (18) .…”

Normative values and factors affecting water‐perfused esophageal high‐resolution impedance manometry for a Chinese population

“…Those authors found a significantly higher limit of IRP in female participants (18.96 vs 14.46 mmHg), even after adjustment for BMI . Similarly, a recent study using 32‐channel solid‐state HRM in 22 healthy volunteers (10 male, 12 female) found a statistically non‐significant pattern of higher median IRP in women than in men (8.2 vs 5.0 mmHg) . The reason for higher IRP‐4s values in females remains unclear.…”