ENDOSCOPIC ESOPHAGEAL MANOMETRY

Objective: We performed through-the-scope-manometry of the esophagus o n 12 patients referred for esophageal symptoms. Methods: A 3-lumen pol yvinyl tube was passed through the biopsy channel of a standard video- endoscope. All patients underwent esophagogastroduodenoscopy with thro ugh-the-scope-manometry as well as a conventional laboratory-based man ometric study; the sequence of the procedures was randomized. Results: Mean lower esophageal sphincter pressure was 18 +/- 11 mm of mercury by both methods. In the lower esophagas, mean wave amplitude was 60 +/ - 25 mm of mercury by through-the-scope manometry and 82 +/- 28 by lab oratory testing. In the upper esophagus, mean wave amplitude was 50 +/ - 26 mm of mercury by through-the-scope manometry and 63 +/- 20 by lab oratory testing, Wave duration tended to be lower by through-the-scope manometry than by laboratory testing in the lower and upper esophagus , In nine patients with normal esophageal motility, 54% of swallows re sulted in a peristaltic wave by the endoscopic study versus 100% for t he laboratory test. Conclusion: Through-the-scope-manometry was able t o accurately measure lower esophageal sphincter pressure compared with laboratory-based manometry. Peristaltic wave amplitude by through-the -scope manometry was reduced compared with laboratory-based manometry, most likely because of the use of dry swallows. Through-the-scope-man ometry has promise as a screening test for esophageal motility disorde rs.