Effect of cold water on esophageal motility in patients with achalasia and non-obstructive dysphagia: A high-resolution manometry study

Alessandra Elvevi, Ivana Bravi, Aurelio Mauro, Delia Pugliese, Andrea Tenca, Ivan Cortinovis, Silvano Milani, Dario Conte, Roberto Penagini

Research output: Contribution to journalArticle

Abstract

Background/Aims: Swallowing of cold liquids decreases amplitude and velocity of peristalsis in healthy subjects, using standard manometry. Patients with achalasia and non obstructive dysphagia may have degeneration of sensory neural pathways, affecting motor response to cooling. To elucidate this point, we used high-resolution manometry. Methods: Fifteen healthy subjects, 15 non-obstructive dysphagia and 15 achalasia patients, after pneumatic dilation, were studied. The 3 groups underwent eight 5 mL single swallows, two 20 mL multiple rapid swallows and 50 mL intraesophageal water infusion (1 mL/sec), using both water at room temperature and cold water, in a randomized order. Results: In healthy subjects, cold water reduced distal contractile integral in comparison with water at room temperature during single swallows, multiple rapid swallows and intraesophageal infusion (ratio cold/room temperature being 0.67 [95% CI, 0.48-0.85], 0.56 [95% CI, 0.19-0.92] and 0.24 [95% CI, 0.12-0.37], respectively). A similar effect was seen in non-obstructive dysphagia patients (0.68 [95% CI, 0.51-0.84], 0.69 [95% CI, 0.40-0.97] and 0.48 [95% CI, 0.20-0.76], respectively), whereas no changes occurred in achalasia patients (1.06 [95% CI, 0.83-1.29], 1.05 [95% CI, 0.77-1.33] and 1.41 [95% CI, 0.84-2.00], respectively). Conclusions: Our data suggest impairment of esophageal reflexes induced by cold water in patients with achalasia, but not in those with non obstructive dysphagia.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
JournalJournal of Neurogastroenterology and Motility
Volume20
Issue number1
DOIs
Publication statusPublished - Jan 2014

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Esophageal Achalasia
Manometry
Deglutition Disorders
Swallows
Water
Healthy Volunteers
Neural Pathways
Peristalsis
Deglutition
Reflex
Dilatation
Temperature

Keywords

  • Deglutition disorders
  • Esophageal achalasia
  • High-resolution manometry

ASJC Scopus subject areas

  • Gastroenterology
  • Clinical Neurology

Cite this

Effect of cold water on esophageal motility in patients with achalasia and non-obstructive dysphagia : A high-resolution manometry study. / Elvevi, Alessandra; Bravi, Ivana; Mauro, Aurelio; Pugliese, Delia; Tenca, Andrea; Cortinovis, Ivan; Milani, Silvano; Conte, Dario; Penagini, Roberto.

In: Journal of Neurogastroenterology and Motility, Vol. 20, No. 1, 01.2014, p. 79-86.

Research output: Contribution to journalArticle

Elvevi, Alessandra ; Bravi, Ivana ; Mauro, Aurelio ; Pugliese, Delia ; Tenca, Andrea ; Cortinovis, Ivan ; Milani, Silvano ; Conte, Dario ; Penagini, Roberto. / Effect of cold water on esophageal motility in patients with achalasia and non-obstructive dysphagia : A high-resolution manometry study. In: Journal of Neurogastroenterology and Motility. 2014 ; Vol. 20, No. 1. pp. 79-86.
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T2 - A high-resolution manometry study

AU - Elvevi, Alessandra

AU - Bravi, Ivana

AU - Mauro, Aurelio

AU - Pugliese, Delia

AU - Tenca, Andrea

AU - Cortinovis, Ivan

AU - Milani, Silvano

AU - Conte, Dario

AU - Penagini, Roberto

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N2 - Background/Aims: Swallowing of cold liquids decreases amplitude and velocity of peristalsis in healthy subjects, using standard manometry. Patients with achalasia and non obstructive dysphagia may have degeneration of sensory neural pathways, affecting motor response to cooling. To elucidate this point, we used high-resolution manometry. Methods: Fifteen healthy subjects, 15 non-obstructive dysphagia and 15 achalasia patients, after pneumatic dilation, were studied. The 3 groups underwent eight 5 mL single swallows, two 20 mL multiple rapid swallows and 50 mL intraesophageal water infusion (1 mL/sec), using both water at room temperature and cold water, in a randomized order. Results: In healthy subjects, cold water reduced distal contractile integral in comparison with water at room temperature during single swallows, multiple rapid swallows and intraesophageal infusion (ratio cold/room temperature being 0.67 [95% CI, 0.48-0.85], 0.56 [95% CI, 0.19-0.92] and 0.24 [95% CI, 0.12-0.37], respectively). A similar effect was seen in non-obstructive dysphagia patients (0.68 [95% CI, 0.51-0.84], 0.69 [95% CI, 0.40-0.97] and 0.48 [95% CI, 0.20-0.76], respectively), whereas no changes occurred in achalasia patients (1.06 [95% CI, 0.83-1.29], 1.05 [95% CI, 0.77-1.33] and 1.41 [95% CI, 0.84-2.00], respectively). Conclusions: Our data suggest impairment of esophageal reflexes induced by cold water in patients with achalasia, but not in those with non obstructive dysphagia.

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