Assessment of esophageal function using provocative tests during high resolution manometry: A single-center experience.

BACKGROUND: Provocative tests were used to provide additional information during performing high resolution manometry (HRM). The study aimed to evaluate whether it is feasible to test esophageal function with different esophageal provocative tests during HRM.

METHODS: 23 healthy volunteers (9 women; mean age 25 years, range 21-30 years) underwent water-perfused HRM. Each subject received 10 liquid swallows, 10 solid swallows, 10 liquid swallows with abdominal compression, and 5 multiple rapid swallowing (MRS).

RESULTS: DCI was significantly greater during abdominal compression than that of solid swallows (p = 0.025). Compared with liquid swallows, there was a significant decrease in CFV during solid swallows (p = 0.04). DL was significantly greater during solid swallows than that of liquid swallows (p < 0.001) or abdominal compression (p < 0.001). IRP 4s was significantly lower during abdominal compression than that of liquids (p < 0.001) or solid swallows (p = 0.006). All subjects had complete inhibition during MRS and increased DCI after MRS as compared with liquid swallows (p < 0.05).

CONCLUSION: Esophageal provocative test may provide additional utility in performing HRM studies. The data for esophageal provocative tests are distinct from standard liquid swallows.