Department of Gastroenterology, Arihant Hospital and Research Centre, 283-A Gumasta Nagar, Indore, 452 009, India.
Indian J Gastroenterol. 2021 Apr;40(2):241-248. doi: 10.1007/s12664-020-01124-w. Epub 2021 Jan 13.
Multiple rapid swallow (MRS) is a complementary test performed during high-resolution esophageal manometry (HREM). The present study was done to assess the MRS findings in patients with gastroesophageal reflux disease (GERD) who have normal peristalsis and minor motility disorders. This is a retrospective analysis from a prospectively maintained database of patients referred for HREM study to our center. The recorded details included age, sex, symptoms with duration, and upper gastrointestinal endoscopy reports. HREM data included basal inspiratory and expiratory pressures, median integrated relaxation pressure, and peristaltic pattern. Three MRS sequences were recorded per patient. The inhibition and contraction phases were interpreted for each MRS sequence. A total of 68 patients (38 normal motility, 30 minor motility disorders) formed the study cohort. Hiatus hernia was common in GERD patients with minor motility disorders (p 0.02). Patients with minor motility disorders were more likely to have poor peristaltic reserve than patients with normal peristalsis (p < 0.05). MRS patterns in inhibition and contraction phases were similar in the three MRS sequences for patients with normal peristalsis, while in patients with minor peristaltic disorders, the inhibition phase was significantly discordant on repetitive MRS (p 0.049). Thus, in GERD patients, those with normal peristalsis were more likely to have normal MRS pattern. On the contrary, those with minor peristaltic disorders had a higher frequency of poor peristaltic reserve and show significant discordance in the inhibition phase of MRS.
多吞咽快速测试（MRS）是在高分辨率食管测压（HREM）期间进行的一项补充测试。本研究旨在评估具有正常蠕动和轻微运动障碍的胃食管反流病（GERD）患者的 MRS 结果。这是对我们中心进行 HREM 研究的患者前瞻性维护数据库的回顾性分析。记录的详细信息包括年龄、性别、症状持续时间以及上消化道内窥镜报告。HREM 数据包括基础吸气和呼气压力、中位综合松弛压力和蠕动模式。每位患者记录了三个 MRS 序列。对每个 MRS 序列的抑制和收缩阶段进行解释。共有 68 名患者（38 名正常运动障碍，30 名轻微运动障碍）组成研究队列。GERD 患者中存在食管裂孔疝与轻微运动障碍有关（p 0.02）。与正常蠕动患者相比，轻微运动障碍患者的蠕动储备较差的可能性更大（p<0.05）。在正常蠕动患者中，三个 MRS 序列的抑制和收缩阶段的 MRS 模式相似，而在轻微蠕动障碍患者中，重复 MRS 时抑制阶段明显不一致（p 0.049）。因此，在 GERD 患者中，具有正常蠕动的患者更有可能具有正常的 MRS 模式。相反，具有轻微蠕动障碍的患者蠕动储备较差的频率更高，并且 MRS 抑制阶段的不一致性更明显。
