Investigation Of The Characteristics Of Esophageal Body Peristalsis In Chinese Using High-resolution Manometry

Aims: To investigate the characteristics of esophageal body peristalsis using high resolutionmanometry in healthy volunteers,and to establish normal values of parameters relevant toesophageal body peristalsis, To investigate effects of different food bolus to esophagealmotilityMethods：We studied110asymptomatic volunteers(gender equivalent) from11differenthospitals in China,with age range of18~65years and average age of37.6±11.6years, Asolid-state high-resolution manometry assembly with4.2mm of outside diameter having36circumferential sensors spaced at1-cm intervals was positioned to record pressures duringswallowing from the velopharynx to stomach in a natural supine position. Each patient wasgiven10liquid swallows (5ml physiological saline each), followed by10solid swallows(bread,2*2*2cm3each).Results:1.10subjects were excluded finally and100subjects were left. There were totally978water swallows and943solid swallows were analyzed.2.All parameters wereexpressed as [Median,P5-P95](Table1).3. The peristaltic velocity and pressure weredifferent between water and solid bolus(P＜0.05). The onset velocity of solid food swallow was slower than water swallow,4.The peristaltic pressure of proximal and distal-esophagealsegment with solid was higher than water swallow, and the distal-esophageal pressurewas higher than proximal pressure in all bolus type.5. There were no statistical significanceof achievement ratios of swallow between water and solid swallow(P>0.05).Conclusion: The characteristics of esophageal body peristalsis were different betweenwater and solid bolus The normative values of esophageal body peristalsis in chinese havebeen obtained. The normative values for most body peristalsis parameters was lower thanthem of the foreign standards. Aims: To investigate the characteristics of esophageal body peristalsis using highresolution manometry in healthy volunteers, To investigate effects of different age andgender to esophageal motilityMethods We studied10asymptomatic volunteers(gender equivalent) from11differenthospitals in China,with age range of18~65years，30of them aged18~30years(groupⅠ),29aged31~40years (groupⅡ),24aged41~50years (group Ⅲ),17aged51~65years (group Ⅳ). A solid-state high-resolution manometry assembly with4.2mm of outsidediameter having36circumferential sensors spaced at1-cm intervals was positioned torecord pressures during swallowing from the velopharynx to stomach in a natural supineposition. Each patient was given10liquid swallows (5ml physiological saline each),followed by10solid swallows (bread,2*2*2cm3each).Results：1. There were no differences of the percentage of successful wet swallowingbetween four age groups in healthy subjects (P>0.05). No significant difference was foundbetween four age groups for the rate of abnormal peristalsis in healthy subjects (P>0.05).2.The pressure and contractile integral of the distal esophagus for female was higher thanmale in all the bolus types.(P<0.05)3. there were no significant difference in esophagealbody peristalsis wave duration time, Onset velocity between the female and male(P>0.05).Conclusion：In this study, we found there were effects of gender and bolus condition otherthan age on esophageal body peristalsis in Chinese healthy volunteers. The amplitude andwave duration time, Onset velocity of peristalsis was similar in four age groups in healthysubjects. Aims: To investigate the efficacy of itopride on reflux symptoms in Non-Erosive RefluxDisease(NERD) patients with esophageal motor abnormalities, and identify the correlationbetween the symptomatic relief and the normalization of esophageal dysmotility.Methods: Thirty-eight NERD patients with esophageal motor abnormalities and typicalgastroesophageal reflux symptoms were enrolled in trial. Subjects received itopride50mgt.i.d. for14days. Symptoms, including heartburn, regurgitation, chest pain and dysphagia,were recorded to evaluate the effect of itopride. The esophageal motility was measured byHigh Resolution Manometry (HRM, Manscan360TM, Given Imaging) before or afteritopride therapy. Each patient was given10liquid swallows (5ml physiological salineeach), followed by10solid swallows (bread,2*2*2cm3each). All scored symptoms andesophageal function were determined in pre-treatment of itopride as baseline.Results:(1) As compared to baseline, there was a significant decrease in the total score ofgastroesophageal reflux symptoms of patients treated with14-days itopride (30.1±9.8vs12.5±6.5，P=0.000). The score of every recorded symptom was lower than baseline(P<0.05).(2) The patients with low LESP decreased after itopride treatment (65.8%vs31.5%,5.4±2.6mmHg vs9.2±4.4mmHg, P＝0.003). There were significant correlationsbetween symptomatic relief and the increase of LES pressure, while there was no statisticalsignificance in the UESP.(3) The esophagus body peristalsis amplitude was higher thanbaseline in different swallowing(P<0.05), the DCI in all type of bolus swallow wereincreased after itopride treatment (P<0.05), the CFV of peristaltic wave in different boluswere no difference between before and after therapy.(4) The achievement ratio of waterand solid swallows were higher than baseline and there was a significant correlationbetween the symptomatic relief and the increase of achievement ratios of swallow withitopride treatment(P <0.05).Conclusion: After two weeks of itopride therapy, the symptoms related to gastroesophageal reflux were improved and some of parameters of esophageal dysmotility were normalizedin the patients with NERD. The symptomatic relief was significantly correlated with thenormalization of esophageal dysmotility.