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High-resolution manometry effectively assessed bolus retention in achalasia patients
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A novel technique that combined high-resolution manometry with impedance to assess bolus height produced results that were similar to timed barium esophagram in patients with achalasia, according to recent study data.
Researchers conducted a prospective study of 20 patients (aged 21 to 79 years; 11 men) that evaluated high-resolution manometry with impedance (HRM) and timed barium esophagram (TBE) to determine any correlations between impedance bolus height (IBH) and barium column height. They designed a protocol to use 200 mL saline for HRM and compared it with 200 mL low-density barium sulfate. Barium and impedance column height measurements occurred at 1 and 5 minutes in an upright position.
At both time points, median IBH and TBE were similar: at 1 minute IBH (IQR, 8-18) and TBE (IQR, 7-19) were 12 cm (P=.9) and at 5 minutes, IBH was 11 cm (IQR, 1-17) vs. 9 cm for TBE (IQR, 4-12; P=.47). Correlations between IBH and barium column at 1 (R=.60) and 5 minutes (R=.86) were considered moderate and excellent, respectively.
When researchers established bolus retention as a barium column or impedance height of least 5 cm, they observed associations at 1 minute (75% concordance) and 5 minutes (95% concordance).
“IBH at 5 minutes had good agreement with barium column height measured at 5 minutes using fluoroscopy during a standard TBE protocol,” the researchers concluded. “Our findings suggest that HRM with impedance using a 200-mL saline challenge can be leveraged to provide a global assessment of esophageal function in achalasia before and after treatment. This tool can be used to assess most of the clinically important parameters associated with achalasia outcomes.”
Disclosure: The researchers report no relevant financial disclosures.
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