Financial support: This work was supported by grant from the Korean Society of the Neurogastroenterology and Motility.
Comparison of bolus transit patterns identified by esophageal impedance to barium esophagram in patients with dysphagia
Article first published online: 10 JUN 2011
© 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus
Diseases of the Esophagus
Volume 25, Issue 1, pages 17–25, January 2012
How to Cite
Cho, Y. K., Choi, M.-G., Oh, S. N., Baik, C. N., Park, J. M., Lee, I. S., Kim, S. W., Choi, K. Y. and Chung, I.-S. (2012), Comparison of bolus transit patterns identified by esophageal impedance to barium esophagram in patients with dysphagia. Diseases of the Esophagus, 25: 17–25. doi: 10.1111/j.1442-2050.2011.01212.x
Potential conflicts of interest: None.
- Issue published online: 11 JAN 2012
- Article first published online: 10 JUN 2011
- barium esophagram;
- bolus transit;
- electric impedance
Bolus transit through the esophagus has not been validated by videoesophagram in patients with dysphagia and changes in impedance with abnormal barium transit have not been described in those patients. The aim of this study was to compare esophageal impedance findings with barium esophagram measurements in patients with dysphagia. The consecutive patients with dysphagia underwent conventional multichannel esophageal impedance manometry, after which a barium videoesophagram was performed simultaneously with multichannel esophageal impedance manometry using a mean of three swallows of barium. Esophageal emptying patterns shown in the esophagogram were classified by the degree of intraesophageal stasis and presence of intraesophageal reflux. Bolus transit patterns in impedance were classified as complete and incomplete transit. Sixteen patients (M : F = 8 : 8, mean age, 47 years) were enrolled. Their manometric diagnosis were normal (n= 6), ineffective esophageal motility (n= 1), diffuse esophageal spasm (DES; n= 2), and achalasia (n= 7). Sixty-three swallows were analyzed. According to impedance analysis, 21/22 swallows with normal barium emptying showed complete transit (96%) and 31/32 swallows with severe stasis showed incomplete transit (97%). Nine swallows with mild stasis showed either complete or incomplete transit patterns in impedance. Swallows with mild barium stasis and complete transit in impedance were observed in patients who had received treatment (two patients with achalasia with history of esophageal balloonplasty and a patient with DES after nifedipine administration). Impedance reflected severe stasis with retrograde barium movement and described typical bolus transit patterns in patients with achalasia and DES. In conclusion, impedance-barium esophagram concordance is high for swallows with normal esophageal emptying and for severe barium stasis in patients with dysphagia.