AI Article Synopsis

  • This study compares smooth muscle contractions in patients with reflux disease to healthy individuals using high resolution manometry (HRM) analysis.
  • Results showed that reflux patients had significantly lower contraction amplitudes and higher rates of fragmented contraction sequences, indicating poorer esophageal motility.
  • The findings suggest that analyzing smooth muscle contraction patterns in HRM could be a useful marker for diagnosing esophageal hypomotility in reflux patients.

Article Abstract

Background: Esophageal peristalsis consists of a chain of contracting striated and smooth muscle segments on high resolution manometry (HRM). We compared smooth muscle contraction segments in symptomatic subjects with reflux disease to healthy controls.

Methods: High resolution manometry Clouse plots were analyzed in 110 subjects with reflux disease (50 ± 1.4 years, 51.5% women) and 15 controls (27 ± 2.1 years, 60.0% women). Using the 30 mmHg isobaric contour tool, sequences were designated fragmented if either smooth muscle contraction segment was absent or if the two smooth muscle segments were separated by a pressure trough, and failed if both smooth muscle contraction segments were absent. The discriminative value of contraction segment analysis was assessed.

Key Results: A total of 1115 swallows were analyzed (reflux group: 965, controls: 150). Reflux subjects had lower peak and averaged contraction amplitudes compared with controls (P < 0.0001 for all comparisons). Fragmented sequences followed 18.4% wet swallows in the reflux group, compared with 7.5% in controls (P < 0.0001), and were seen more frequently than failed sequences (7.9% and 2.5%, respectively). Using a threshold of 30% in individual subjects, a composite of failed and/or fragmented sequences was effective in segregating reflux subjects from control subjects (P = 0.04).

Conclusions & Inferences: Evaluation of smooth muscle contraction segments adds value to HRM analysis. Specifically, fragmented smooth muscle contraction segments may be a marker of esophageal hypomotility.

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Source
http://dx.doi.org/10.1111/j.1365-2982.2012.01930.xDOI Listing

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