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Esophageal motility testing made easy by C G Bremner

By C G Bremner

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RV\6: : '. Respiratipn : Copyrighted Material . . . ~ . ' . 128 Esophageal Motility Testing Made Easy Slow Motorized Pull- Through-cont'd Fig. 2-11 Asymmetry is demonstrated in this slow motorized pull-through recording of the LES. All four channels (3 to 6) are recorded at the same level. In channels 3, 5, and 6 the hiatal component of the LES is accentuated. Fig. 2-12 Regression analysis of slow motorized pull-through (SMPT) and stationary pull-through (SPT) methods.

The difference between multipeaked (E) and repetitive (F) is that the pressure between two consecutive peaks returns to the baseline in the latter. phagus 331 Fig. 2-15 c ... "'"" i :i. ,i •. f . ,. r : 1:. r· i • :J -: 0; 0 . I. 1', 1 '. i,', . I ~ . , ":... br} .. •....... ~-:.... ····· ~ below DES 61 A A A Jl A c AA I I "*" I I Ut I r ~ I ":0- * ~ ----"'""'- I r }L A A I PERISTALTIC SEQUENCE SIMULTANEOUS SEQUENCE (prop. speed < 20 cm/s) (prop. speed > 20 cm/s) Fig. 2-16 D INTERRUPTED SEQUENCE "*" -""- DROPPED SEQUENCE "* = amplitude Copyrighted~ial Eft~ W% :~~ !

Air precedes the bolus into the open UES. As the bolus flows through the UES it begins to slow down as frictional forces begin to play an increasingly dominant role. The subatmospheric pressure disappears as the bolus moves into the esophagus. Flow is now 30 to 60 cm/sec. Pressure and inertia are still dominant, but friction assumes greater importance. As the bolus moves from the UES into the esophagus, it rapidly decelerates and slows to 2 to 4 cm/sec. The stripping wave transforms into a peristaltic wave as rapid change gives way to slow change.

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