Apple sauce improves detection of esophageal motor dysfunction during high-resolution manometry evaluation of XXXX .

@entity1 @entity662 @entity4681 @entity1957 @entity1282 @entity551
BACKGROUND: Esophageal manometry utilizes water swallows to evaluate esophageal @entity4681 in @entity1 with @entity1282 , @entity662 , or reflux symptoms. Although manometry is the gold standard for evaluation of these symptoms, @entity1 with @entity1282 often have normal results in manometry studies. AIM: The objective of this work was to test the hypothesis that challenging the esophagus with viscous apple sauce boluses uncovers @entity4681 in @entity1 with @entity1282 not seen when using water swallows. METHODS: High-resolution esophageal manometry was performed using ten water swallows followed by ten apple sauce swallows in consecutive subjects presenting with @entity1282 . Subjects with grossly abnormal water swallow evaluations were excluded. Each swallow was categorized as normal, @entity551 (distal isobaric contour plots of < 30 mmHg over >5 cm), or simultaneous (distal esophageal velocity >=  8.0 cm/s). Ineffective esophageal motility (IEM) was defined as >=  30% @entity551 swallows, and pressurization was defined as >=  20% simultaneous pressure waves. RESULTS: Data from 41 subjects was evaluated. Overall, 96.3% of water swallows were normal, 2.9% @entity551 , and 0.7% simultaneous. Only 70.3% of viscous swallows were normal; 16.7% were @entity551 and 13.0% were simultaneous (P < 0.001 all groups). Seven (17.1%) met criteria for IEM, and pressurization with viscous swallows was observed for nine (22.0%). Fourteen subjects (34.1%) had abnormal results from viscous studies. The presence of any abnormal water swallows was predictive of abnormal viscous swallows (OR = 9.00, CI = 2.15-80.0), although the presence of @entity551 or simultaneous water swallows was not associated with IEM (OR = 0.63, CI = 0.16-2.17) or pressurization (OR = 7.00, CI = 0.90-315.4) with viscous apple sauce. CONCLUSIONS: Apple sauce challenge increased identification of classifiable @entity1957 in @entity1 with @entity1282 and may be preferred to alternative bolus materials.
