Influence of Ineffective Swallows on Esophageal Motility and Gastroesophageal Reflux
10.3969/j.issn.1008.7125.2022.01.002
- Author:
Xuemin YAO
1
;
Bixing YE
1
;
Meifeng WANG
1
;
Lin UN
1
;
Liuqin JIANG
1
;
Xuemin YAO
2
;
Ying JIN
2
;
Liuqin JIANG
3
Author Information
1. Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University
2. Department of Gastroenterology, Suzhou Ninth People's Hospital
3. Department of Gastroenterology, Jinhu County People's Hospital
- Publication Type:Journal Article
- Keywords:
Acid Reflux;
High-Resolution Manometry;
Ineffective Esophageal Motility;
Ineffective Swallows;
Multichannel Intraluminal Impedanee-pH Monitoring
- From:
Chinese Journal of Gastroenterology
2022;27(1):9-16
- CountryChina
- Language:Chinese
-
Abstract:
Background : Studies showed that esophageal body dysmotility is associated with gastroesophageal reflux disease (GERD), however, their interactions are still unclear. Aims: To explore the influence of proportion of ineffective swallows on esophageal motility and gastroesophageal reflux in esophageal high-resolution manometry (HRM). Methods: Patients who completed esophageal HRM and 24 h esophageal impedanee-pH monitoring and were identified as normal esophageal motility or mild dysmotility from March 2018 to December 2019 at the First Affiliated Hospital of Nanjing Medical University were recruited retrospectively. According to the times of ineffective swallows in 10 warm water swallows in HRM, these patients were allocated into four groups; Group A (0 times), Group B (1-4 times), Group C (5-7 times), Group D (8-10 times). The parameters of esophageal HRM and 24 h esophageal impedance-pH monitoring were analyzed, and the value of ineffective swallows for assistant diagnosis of pathological acid reflux was assessed. Results: A total of 142 patients were included. There were no significant differences in abnormal manometric parameters between the four groups (all P > 0. 05). In Group D, the number of weak and non-peristalsis were increased, while the mean and maximum value of distal contractile integral (DCI) were decreased as compared with those in Group A and Group B (all P < 0. 05). Between Group C and Group D, the differences in mean and maximum DCI value were significant (all P < 0. 05). As the times of ineffective swallows increased, the acid exposure time (AET) and DeMeester score gradually increased from Group A to Group D (all P < 0. 05). Times of ineffective swallows and weak peristalsis were moderately and positively correlated with AET, DeMeester score, and the total number of acid exposure (all P < 0. 05). ROC curve analysis revealed that the area under the curve (AUC) of ineffective swallows for assistant diagnosis of pathological acid reflux was 0. 625 (95 % CI; 0.523-0. 727, P = 0. 027); the optimal cut-off value was 4. 5, and the sensitivity and specificity were 62. 9% and 61. 7 %, respectively. The diagnostic performance of weak peristalsis was superior to that of non-peristalsis (AUC: 0. 625 vs. 0. 590). Conclusions: Different proportions of ineffective swallows suggest different clinical significance. The clinical relevance of ineffective swallows > 70 % might be most significant, and to a certain extent, can predicts pathological acid reflux.
