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- Title
Assessing Bolus Retention in Achalasia Using High-Resolution Manometry With Impedance: A Comparator Study With Timed Barium Esophagram.
- Authors
Cho, Yu K; Lipowska, Anna M; Nicodème, Frédéric; Teitelbaum, Ezra N; Hungness, Eric S; Johnston, Elyse R; Gawron, Andrew; Kahrilas, Peter J; Pandolfino, John E
- Abstract
OBJECTIVES:The aim of this study was to assess whether high-resolution impedance manometry (HRIM) could be used to assess bolus retention similar to the timed barium esophagram (TBE).METHODS:Twenty achalasia patients (10 males, aged 21-79 years) were prospectively evaluated with HRIM and TBE to determine the correlation between barium column height and the impedance bolus height (IBH). The TBE protocol used a 200-ml barium challenge and the HRIM protocol used a 200-ml saline challenge protocol. Both protocols were performed in an upright position and the heights of the barium and impedance columns were measured at 1 and 5 min. Analysis of IBH was performed with a topographic technique and a spatial impedance variation plot.RESULTS:There was no significant difference between the median IBH and barium column at 1 min (IBH: 12.0 cm (interquartile range (IQR), 8.0-18.0); TBE: 12.0 cm (IQR, 7.0-19.0); P=0.90) or at 5 min (IBH: 11.0 cm (IQR, 1.0-17.0); TBE: 9.0 cm (IQR, 4.0-12.0); P=0.47). In addition, the correlation between the two measurements at 1 and 5 min was 0.60 and 0.86, respectively. Using a barium column or impedance height of >5.0 as a definition of bolus retention was associated with 75% concordance at 1 min and 95% concordance at 5 min.CONCLUSIONS:There was excellent agreement between TBE and high-resolution impedance manometry (HRIM) for assessing bolus retention at 5 min. Thus, HRM with impedance may be used as a single test to assess bolus retention and motor function in the management of achalasia.
- Subjects
ESOPHAGEAL achalasia; HIGH resolution imaging; DIAGNOSTIC imaging; BIOELECTRIC impedance; MEDICAL protocols; COMPARATIVE studies; DIAGNOSIS
- Publication
American Journal of Gastroenterology (Springer Nature), 2014, Vol 109, Issue 6, p829
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1038/ajg.2014.61