Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals
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Date
2017-05-07
Authors
Cisternas, Daniel
Scheerens, C
Omari, Taher
Monrroy, H
Hani, A
Leguizamo, A
Bilder, C
Ditaranto, A
Ruiz de Leon, A
Perez de la Serna, J
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Rights
© 2017 John Wiley & Sons, Inc.
Rights Holder
John Wiley & Sons, Inc.
Abstract
Background
Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals.
Methods
High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5‐point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns.
Key Results
One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R2 up to .70).
Conclusion and Inferences
Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility.
Description
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© 2017 John Wiley & Sons, Inc. All rights reserved.
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Keywords
bolus perception, esophageal shortening,, Manometry, bolus transit, automated impedance manometry (AIM), High resolution manometry (HRM)
Citation
Cisternas, D., Scheerens, C., Omari, T., Monrroy, H., Hani, A., Leguizamo, A., … Serra, J. (2017). Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals. Neurogastroenterology & Motility, 29(9), e13088. https://doi.org/10.1111/nmo.13088