Pharyngeal swallowing and oesophageal motility during a solid meal test: a prospective study in healthy volunteers and patients with major motility disorders

Hollenstein, Michael; Thwaites, Philip J.; Bütikofer, Simon; Heinrich, Henriette; Sauter, Matthias; Ulmer, Irina; Pohl, Daniel; Ang, Daphne; Eberli, Daniel; Schwizer, Werner; Fried, Michael; Distler, Oliver; Fox, Mark; Misselwitz, Benjamin

doi:10.1016/s2468-1253(17)30151-6

Cited by 71 publications

(130 citation statements)

References 29 publications

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“…Esophageal symptoms, especially the dysphagia, were seen more frequently in solid bolus swallows. Adding solid bolus swallow in the procedure of esophageal manometry, either single solid bolus swallow or solid test meal, improved the diagnostic ability of esophageal motility disorders and the assessment of the symptomatic dysmotility . Hence, solid bolus swallow was accepted as one of the provocative tests during esophageal manometry …”

Section: Introductionmentioning

confidence: 99%

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

Xiang

Wang

et al. 2019

Neurogastroenterology Motil

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Background The results of the esophageal body motility differences between liquid and solid swallows from high‐resolution manometry (HRM) studies are not consistent. The information of the frequency of ineffective liquid and solid bolus swallows in healthy individuals during HRM procedure is limited. The normative values of the HRM parameters of both liquid and solid swallows for Chinese population are lacking. Methods The esophageal HRM data of 101 healthy volunteers from multicenters in China were analyzed. The values of the HRM parameters were summarized and compared between liquid and solid swallows. The frequencies of ineffective liquid and solid swallows were summarized. Results Esophagus contracted stronger and slower in solid bolus swallows than water swallows with HREM. Ineffective water swallow (DCI < 450 mm Hg.s.cm) and ineffective bread swallow (DCI < 800 mm Hg.s.cm) were frequently seen in asymptomatic individuals. The adding of bread swallows to the HREM procedure might cause diagnostic change in about 15.8% (16/101) of the asymptomatic individuals. Conclusions The vigor and velocity of the esophageal peristalsis between liquid and solid bolus swallows are different. Ineffective water and solid bolus swallows are not rare. Adding solid bolus swallows brings diagnostic change, and it may be needed routinely for the HRM procedure.

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Section: Introductionmentioning

confidence: 99%

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

Xiang

Wang

et al. 2019

Neurogastroenterology Motil

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“…Achalasia subtypes are recognized, and the value of provocative testing in assessing esophageal contraction reserve has been established, utilized by >75% of motility centers worldwide . HRM has an evolving role in the evaluation of pharyngeal motor function and bolus transit, and frequency of pharyngeal swallowing has been defined as the rate‐limiting step in food ingestion in healthy controls using a standardized test meal . Several key meetings and consensus group publications, including the International GERD Consensus Group, Esophageal Diagnostic Advisory Panel, and the International Working Group for Disorders of GI Motility & Function, have weighed in on the value of HRM, including specific protocols for nontraditional indications .…”

Section: Novel Endoscopic Evaluationmentioning

confidence: 99%

“…Evaluation of motor patterns following standardized test meals utilizing HRM with impedance can assist in the diagnosis of behavioral syndromes, including rumination and supragastric and gastric belching. Normative values have been reported, and broader utilization of this provocative option will benefit refractory symptomatic tests . Attempts to reproduce symptoms using provocative testing and ambulatory manometry can be useful options in refractory symptomatic states.…”

Section: How To Perform the Standard Testmentioning

confidence: 99%

Indications and interpretation of esophageal function testing

Gyawali¹,

Bortoli

Clarke

et al. 2018

Annals of the New York Academy of Sciences

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Esophageal symptoms are common, and can arise from mucosal, motor, functional, and neoplastic processes, among others. Judicious use of diagnostic testing can help define the etiology of symptoms and can direct management. Endoscopy, esophageal high-resolution manometry (HRM), ambulatory pH or pH-impedance manometry, and barium radiography are commonly used for esophageal function testing; functional lumen imaging probe is an emerging option. Recent consensus guidelines have provided direction in using test findings toward defining mechanisms of esophageal symptoms. The Chicago Classification describes hierarchical steps in diagnosing esophageal motility disorders. The Lyon Consensus characterizes conclusive evidence on esophageal testing for a diagnosis of gastroesophageal reflux disease (GERD), and establishes a motor classification of GERD. Taking these recent advances into consideration, our discussion focuses primarily on the indications, technique, equipment, and interpretation of esophageal HRM and ambulatory reflux monitoring in the evaluation of esophageal symptoms, and describes indications for alternative esophageal tests.

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“…A key insight from this work is that dysphagia and other symptoms are rarely caused by abnormal motility unless it is accompanied by impaired function such as bolus retention or reflux [11,12]. This approach has been applied to assess oesophageal function during 'rapid drink challenge' and eating a solid test meal (STM) [13][14][15]. In serial diagnostic studies, this approach increased the diagnostic yield of HRM for major oesophageal motility disorders.…”

Section: Question 1: What Are the Most Frequent Reasons Or Indicationmentioning

confidence: 99%

Functional Diagnosis in Upper and Lower Gastrointestinal Diseases: Relevance for Conservative, Interdisciplinary and Surgical Therapies

et al. 2018

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Pharyngeal swallowing and oesophageal motility during a solid meal test: a prospective study in healthy volunteers and patients with major motility disorders

Cited by 71 publications

References 29 publications

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

The differences in the esophageal motility between liquid and solid bolus swallows: A multicenter high‐resolution manometry study in Chinese asymptomatic volunteers

Indications and interpretation of esophageal function testing

Functional Diagnosis in Upper and Lower Gastrointestinal Diseases: Relevance for Conservative, Interdisciplinary and Surgical Therapies

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