Characteristics of oesophageal bolus transport in patients with mild oesophagitis.

OBJECTIVE

Patients with gastroesophageal reflux disease (GORD) frequently have oesophageal motility disturbance. However, detailed data about bolus transport characteristics in these patients are still lacking. In the present study the new technology of concurrent impedance manometry was applied for characterization of oesophageal motor function in patients with mild GORD.

METHODS

Oesophageal motility testing was performed in 25 patients with mild GORD (group 1) as compared to 25 healthy subjects (group 2) employing the technique of concurrent impedancometry and manometry. Oesophageal motility as well as patterns and parameters of bolus transport after the swallowing of saline or yogurt were analysed.

RESULTS

According to manometry the velocity of the contraction wave was similar in both groups. Mid-distal contraction amplitude in group 1 was still in the normal range but significantly lower than in group 2 (57.4+/-4.5 mmHg vs 91.4+/-7.5 mmHg for saline, and 47+/-4.1 vs 80.7+/-9.4 mmHg for yogurt). According to impedance measurements, bolus transport was significantly slower (3.6+/-0.1 vs 4.0+/-0.1 cm/s for saline and 3.0+/-0.1 vs 3.2+/-0.1 cm/s for yogurt), and post-deglutitive impedance was significantly lower in group 1: 2110 omega+/-116 omega versus 2542 omega+/-152 omega (P<0.01) with saline and 1862 omega+/-108 omega versus 2348 omega+/-148 omega with yogurt (P<0.01). GORD patients showed several pathological bolus transport patterns, which were not observed in healthy subjects. Gastroesophageal liquid reflux was observed between the swallows.

CONCLUSIONS

In patients with mild GORD concurrent impedancometry and manometry is sufficiently sensitive for the detection of minor oesophageal dysmotility. Several pathological features have been characterized including delayed bolus transport, impaired propulsive volume clearance, pathological transport patterns and pathological reflux patterns.