Distal esophageal impedance measured by high-resolution esophageal manometry with impedance suggests the presence of Barrett’s esophagus

Rahul Kataria, Benjamin Rosenfeld, Zubair Malik, Martha Harrison, Michael S. Smith, Ron Schey, Henry P. Parkman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background/Aims Barrett’s esophagus (BE) is characterized by intestinal metaplasia in the distal esophagus. The aims of this study are to: (1) Compare baseline distal esophageal impedance (DEI) using high-resolution esophageal manometry with impedance (HREMI) in patients with BE, esophagitis, and healthy volunteers and (2) Correlate length of low impedance on HREMI in patients with BE to the length of endoscopic BE. Methods Patients with BE or esophagitis who underwent HREMI were included. Ten volunteers had HREMI. Baseline DEI was calculated from HREMI using the landmark segment. In patients with BE, the impedance was plotted to measure the extent of plotted low impedance (PLI) and visual low impedance (VLI). Lengths of VLI and PLI were correlated to endoscopic length of BE by Prague score. Results Forty-five patients were included (16 BE; 19 esophagitis; 10 volunteers). BE patients had lower baseline DEI at the first, second, and third sensors above the lower esophageal sphincter (mean ± SEM: 1.37 ± 0.45, 0.97 ± 0.27, and 0.81 ± 0.20) compared to volunteers (8.73 ± 0.60, 8.20 ± 0.73, and 6.94 ± 0.99; P < 0.001). Baseline DEI was lower in BE than esophagitis patients (2.98 ± 0.65, 2.49 ± 0.56, and 2.01 ± 0.51) at the first, second, and third sensors (P < 0.052 for second and third sensors); ie, BE < esophagitis < controls. PLI and VLI had a stronger correlation to circumferential score (r2 = 0.84 and 0.83) than maximal score (r2 = 0.76 and 0.68). Conclusions Baseline DEI is lower in BE compared with esophagitis and healthy volunteers. The length of low impedance correlates to the endoscopic extent of BE. Thus, impedance values during HREMI may help suggest the presence and extent of BE or esophagitis.

Original languageEnglish
Pages (from-to)344-351
Number of pages8
JournalJournal of Neurogastroenterology and Motility
Volume26
Issue number3
DOIs
StatePublished - 1 Jul 2020
Externally publishedYes

Keywords

  • Barrett esophagus
  • Electric impedance
  • Esophagitis
  • Gastroesophageal reflux

Fingerprint

Dive into the research topics of 'Distal esophageal impedance measured by high-resolution esophageal manometry with impedance suggests the presence of Barrett’s esophagus'. Together they form a unique fingerprint.

Cite this