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111 SLEEVE SENSOR CATHETER IS MORE RELIABLE IN THE EVALUATION OF UPPER ESOPHAGEAL SPHINCTER PRESSURE THAN THE STATION PULL-THROUGH TECHNIQUE LWC Liu, M Thabane, E Fachnie, D Armstrong The basal tone of the upper esophageal sphincter (UES) is important in preventing the reflux of esophageal contents into the respiratory tract and the entry of air into the esophagus during inspiration. The UES pressure (UESP) profile has not been well studied and its relationship to gastrointestinal symptoms such as globus or oropharyngeal dysphagia is unclear. This is, in part, due to the lack of a reliable method to study the UESP. The use of Dent sleeve (DS) to study the lower esophageal sphincter pressure has been established. However, the reliability of the DS in evaluating the UESP is unknown.
Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario
AIM: We compared the reliability of the DS and another commonly used technique, station pull-through (PT), in assessing the UESP.
METHOD: The resting UESPs of 20 healthy volunteers, 19 to 50 years old, were measured using PT followed by DS, connected to a water perfusion system, during the same visit; measurements were repeated on two separate days - day 1 and day 2. The average resting UESPs were obtained from five independent measurements between wet swallows using the DS catheter, and two independent measurements from each of the five perfusion channels (5 cm apart and oriented circumferentially, a total of 10 measurements per patient per visit) using the PT catheter. Correlation coefficient for test-retest reliability between day 1 and day 2 and variability within test (ie, internal consistency) on the same day of the two measurement techniques were obtained.
RESULTS: On day 1 and day 2, the resting UESPs were 57.3±20.1 mmHg and 59.1±24.6 mmHg using the PT catheter and were 91.7±11.4 mmHg and 96.7±9.1 mmHg using the DS catheter, respectively. The internal consistency within each test (Crobanch alpha) was 92.9% and 96.9% for DS and only 55.1% and 63.9% for PT, on day 1 and day 2, respectively. The correlation coefficient for test-retest reliability between different days was 86.0% for DS and only 54.8% for PT.
CONCLUSION: Our data demonstrate that the DS catheter is more consistent and reliable than the PT technique in the evaluation of UESP. The resting UESP measured by the DS catheter was higher than that determined by the PT technique, which is consistent with previously published observation. We propose that the DS catheter should be used to study the UESP particularly when repeat measurements are required to follow treatment response.
Supported by the PSI Foundation