Distal Oesophageal Motility Characteristics in Relation to Amplitude of Contraction in Healthy Persons

Abstract

Objectives: We wanted to apply a new ‘vertical’ approach in the analysis of oesophageal contraction data by describing variables of oesophageal function in relation to the amplitude of contraction. Methods: Twenty-four-hour oesophageal manometry was performed in 20 healthy volunteers (11 women and 9 men; mean age, 47.5 years). Computer analysis was performed in pressure windows at 10, 15, 20, 30, 40, 50, 60, 70, and 80 mm Hg. Within each window two variables were extracted: the distribution (%) of peristaltic contractions and median duration (sec) of contractions. Results: The percentage of peristaltic contractions increased with increasing amplitude of contractions during the upright position (15–20 mm Hg window: mean (±SD) 68.2% (±13.3%), versus 70–80 mm Hg window: 85.0% (±13.0%) (P < 0.001)) and meal periods (66.9% (±13.8%) versus 92.2% (±11.2%) (P < 0.001)) but not in the supine position (75.9% (±14.6%) versus 73.5% (±16.1%) (P = 0.64)). Contraction duration diminished with increasing contraction amplitude (upright, 15–20 mm Hg window: 3.2 sec (±1.5 sec) versus 70–80 mm Hg window: 1.5 sec (±1.0 sec) (P < 0.0001); meal: 3.8 sec (±1.7 sec) versus 1.9 sec (±1.1 sec) (P < 0.01); supine: 4.1 sec (±3.0 sec) versus 2.2 (±1.5 sec) (P = 0.03)). The percentage of peristaltic contractions was lower during the supine periods than during meals and upright periods at high amplitudes (70–80 mm Hg window; P < 0.05). The number of contractions decreased linearly on a logarithmic scale with pressure window amplitude. Conclusions: Pressure wave amplitude and organization were closely related. Accurate base-line determination and delineation are critical for the interpretation of oesophageal manometric recordings.

Key Words:

• Manometry
• manometry instrumentation
• monitoring
• physiologic
• oesophagus
• physiology
• peristalsis