Multiple intraluminal electrical impedancometry for recording of upper gastrointestinal motility: Current results and further implications

This review focuses on current aspects of the novel technology of multiple intraluminal electrical impedance measurement. It presents methodological f eatures, summarizes current results, and discusses potential implications f or further research. The impedance technique assesses a bolus transport and its associated peristalsis. Validation studies showed a good analogy betwe en physically deduced impedance characteristics and characteristics derived from cineradiography and manometry. From the impedance tracings, it is pos sible to distinguish between resting states, bolus transit, and wall contra ction. Characteristics of a peristaltic wave can be obtained. In human stud ies, esophageal and small intestinal peristaltic patterns can quantitativel y and qualitatively be assessed. A high resolution recording of bolus movem ents with interesting details of transport and mixing can be obtained. On t he basis of several prior characterized impedance tracings duodenal contrac tile patterns have been classified, and the interdigestive and postprandial states characterized. For reflux evaluation the impedance technique was es pecially useful for the detection of nonacid gastroesophageal reflux, which is not detectable by pH monitoring. In summary, the main impact of the imp edance technique is its capability to characterize esophageal and intestina l chyme transport. Important data on luminal chyme transport have been obta ined. This technique is developing into an interesting investigative tool t o complement standard techniques for study of upper GI motility, in particu lar for basic research. (Am J Gastroenterol 1999;94:306-317. (C) 1999 by Am . Cell. of Gastroenterology).