SMALL-BOWEL MANOMETRY - SHORT OR LONG RECORDING SESSIONS

The study of small bowel motility in humans is commonly done by one of two techniques: short-term recording in a stationary patient or long- term recording in an ambulatory patient, To compare the diagnostic yie ld of short- and long-term manometric studies of small intestinal moti lity, we reviewed all prolonged records performed in our center over t he years, Long-term studies that included less than 6 hr of recording during fasting or less than 5 hr during sleep and short-term studies u sing the perfused tube technique were excluded, leaving 91/121 tracing s suitable for review, We analyzed the first 3 hr of the fasting perio d and the first 2 hr of the postprandial period on one occasion and th e whole tracing on another; the fasting, postprandial and sleep period were analyzed separately. This allowed us to compare short and long r ecording sessions in the same patient. The mio analyses agreed in 81/9 1 of the cases. In 7/10 patients a study was diagnosed as abnormal in the short recording but was considered normal after review of the long recording, while the opposite occurred in the remaining three, Period s of sleep and fasting contributed similarly to the change in diagnosi s. In another 6 patients with equivocal abnormalities during the short period, the long period helped to establish the diagnosis of normalit y with confidence, Most of the improvement in the long-term study came from extension of the studies during fasting to 6-7 hr from 3 hr. Lon g-term records of small bowel motility, including study during sleep e nhance the diagnostic accuracy of the test. Accuracy can be improved a lso simply by prolonging the recording during fasting.