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Type: Journal article
Title: Impaired bolus clearance in asymptomatic older adults during high-resolution impedance manometry
Author: Cock, C.
Besanko, L.
Kritas, S.
Burgstad, C.
Thompson, A.
Heddle, R.
Fraser, R.
Omari, T.
Citation: Neurogastroenterology and Motility, 2016; 28(12):1890-1901
Publisher: Wiley
Issue Date: 2016
ISSN: 1350-1925
Statement of
C. Cock, L. Besanko, S. Kritas, C.M. Burgstad, A. Thompson, R. Heddle, R.J.L. Fraser, T.I. OmariI
Abstract: Background: Dysphagia becomes more common in old age. We performed high-resolution impedance manometry (HRIM) in asymptomatic healthy adults (including an older cohort >80 years) to assess HRIM findings in relation to bolus clearance. Methods: Esophageal HRIM was performed in a sitting posture in 45 healthy volunteers (n = 30 young control, mean age 37 ± 11 years and n = 15 older subjects aged 85 ± 4 years) using a 3.2-mm solid-state catheter (Solar GI system; MMS, Enschede, The Netherlands) with 25 pressure (1-cm spacing) and 12 impedance segments (2-cm intervals). Five swallows each of 5- and 10-mL liquid and viscous bolus were performed and analyzed using esophageal pressure topography metrics and Chicago classification criteria as well as pressure-flow parameters. Bolus transit was determined using standard impedance criteria. A p-value <0.05 was considered significant. Key Results: Impaired bolus clearance occurred more frequently in asymptomatic older subjects compared with young controls (YC) during liquid (40 vs 18%, χ2 = 4.935; p < 0.05) and viscous (60 vs 17%; χ2 = 39.08; p < 0.001) swallowing. Longer peristaltic breaks (p < 0.05) and more rapid peristalsis (L: p < 0.004, V: p = 0.003) occurred in the older cohort, with reduced impedance-based clearance for both bolus consistencies (L: p < 0.05, V: p < 0.001). Decreased peristaltic vigor (distal contractile integral <450 mmHg/s/cm) was associated with reduced liquid clearance in both age groups (p < 0.001) and of viscous swallows in the older group (p < 0.001). Impedance ratio, a marker of bolus retention, was increased in older subjects during liquid (p = 0.002) and viscous (p < 0.001) swallowing. Conclusions & Inferences: Impaired liquid and viscous bolus clearance, esophageal pressure topography, and pressure-flow changes were seen in asymptomatic older subjects.
Keywords: Aging; bolus clearance; manometry; presbyesophagus; pressure-flow analysis
Rights: © 2016 John Wiley & Sons Ltd
RMID: 0030084173
DOI: 10.1111/nmo.12892
Appears in Collections:Medicine publications

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