Vigor of peristalsis during multiple rapid swallows is inversely correlated with acid exposure time in patients with NERD.

Martinucci, I; Savarino, E V; Pandolfino, J E; Russo, S; Bellini, M; Tolone, S; Tutuian, Radu; Roman, S; Furnari, M; Frazzoni, M; Macchia, L; Savarino, V; Marchi, S; de Bortoli, N (2016). Vigor of peristalsis during multiple rapid swallows is inversely correlated with acid exposure time in patients with NERD. Neurogastroenterology and motility, 28(2), pp. 243-250. Wiley 10.1111/nmo.12719

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BACKGROUND Multiple rapid swallowing (MRS) during high-resolution manometry (HRM) is increasingly utilized as provocative test to assess esophageal peristaltic reserve. The aim of this study was to evaluate the correlation between MRS response and impedance and pH (MII-pH) parameters in endoscopy negative heartburn (ENH) patients. METHODS We enrolled consecutive ENH patients, who underwent HRM and MII-pH study, with a selected MII-pH profile: abnormal MII-pH (pH+/MII+); normal MII-pH (pH-/MII-). HRM was performed with 10 wet swallows (WS) and one MRS. Mean distal contractile integral (DCI) during WS and MRS were calculated. MII-pH parameters including acid exposure time (AET), reflux events, baseline impedance levels (BI) and the efficacy of chemical clearance evaluated with the postreflux swallow-induced peristaltic wave (PSPW) index were measured. KEY RESULTS We analyzed 103 patients: 49 MII+/pH+ (27 male), and 54 MII-/pH- (19 male). Mean age was similar between the two groups. As expected, mean AET and number of refluxes were higher in pH+/MII+ (p < 0.05). HRM was normal in all selected patients. Mean DCI-WS was similar between two groups (p = n.s.). Mean DCI-MRS- was higher in MII-/pH- vs MII+/pH+ (p < 0.05). The increase in DCI-MRS was inversely correlated with AET (-0.699; p < 0.001) and directly correlated with BI values (0.631; p < 0.001) and PSPW index (0.626; p < 0.001). CONCLUSIONS & INFERENCES Following MRS, patients with abnormal impedance-pH test showed suboptimal contraction response as compared with those with normal impedance-pH test. Moreover, MRS response was inversely correlated with AET and directly correlated with BI values and PSPW index.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Tutuian, Radu

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1350-1925

Publisher:

Wiley

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

03 May 2017 09:59

Last Modified:

03 May 2017 09:59

Publisher DOI:

10.1111/nmo.12719

PubMed ID:

26661383

Uncontrolled Keywords:

acid exposure time; gastro-esophageal reflux disease; high-resolution manometry; multiple rapid swallow

BORIS DOI:

10.7892/boris.94406

URI:

https://boris.unibe.ch/id/eprint/94406

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