Effects of different food bolus on esophageal motility in patients with non-obstructive esophageal dysphagia / 中华消化杂志

ABSTRACT

Objective To analyze the effects of different food bolus on esophageal motility in patients with non-obstructive esophageal dyshagia by high-resolution esophageal manometry.Methods From March 2014 to June 2015,48 patients with non-obstructive esophageal dysphagia and 12 healthy volunteers (healthy control group) were enrolled.High-resolution manometry was tested when swallowing liquid food,semisolid food and solid food.The lower esophageal sphincter pressure (LESP),4 second integrated relaxation pressure (4 s IRP),distal contractile integral (DCI),distal latency (DL),and breaks were analyzed.T test was performed for statistical analysis.Results According to the 2014 Chicago classification standard,among 48 patients with dysphagia,esophageal dysmotility was diagnosed in 35 patients (72.9％),while 13 patients (27.1％) had normal esophageal motility,and the most common type of esophageal motility disorder was ineffective esophageal motility (31.2％,15/48).The LESP of the healthy control group was (10.85±3.75) mmHg (1 mmHg=0.133 kPa) and 4 s IRP was (1.90±0.84) mmHg.The LESP of dysphagia group was (12.20 ±8.93) mmHg and 4 s IRP was (3.25± 1.02) mmHg.There was no significant difference in LESP and 4 s IRP between two groups (both P＞0.05).The DCIs of liq(u)id swallows,semisolid swallows and solid swallows of healthy control group were (589.00±292.90),(690.17±52.41) and (808.00±448.53) mmHg · s · cm,respectively,which were significantly lower than those of complete normal group in Chicago classification ((1 346.62 ± 244.83),(1 542.46±231.19) and (1 890.31±363.26) mmHg · s · cm;t=4.76,4.68 and 3.79;all P=0.001).The DL of solid swallows of healthy control group was (7.72± 1.15) s,which was significantly lower than that of complete normal group in Chicago classification ((9.00±1.23) s;t=2.61,P=0.021).The breaks of liquid swallows,semisolid swallows and solid swallows of healthy control group were (2.33 ±1.74),(2.37±1.72) and (1.53± 1.22) cm,respectively,which were higher than those of complete normal group in Chicago classification ((0.58±0.48),(0.52±0.47) and (0.85±0.53) cm),and the differences were statistically significant (t =3.02,3.68 and 2.54,all P ＜ 0.05).Conclusions The most common type of esophageal motility disorder in patients with non-obstructive esophageal dysphagia is ineffective esophageal molitity.When swallowing food,the patients with dysphagia but normal results of esophageal manometry according to Chicago classification require more strength of the esophagus,more complete contraction and longer peristaltic time to swallow food bolus.