TY - JOUR
T1 - Chronic cough is associated with long breaks in esophageal peristaltic integrity on highresolution manometry
AU - Bennett, Michael C.
AU - Patel, Amit
AU - Sainani, Nitin
AU - Wang, Dan
AU - Sayuk, Gregory S.
AU - Gyawali, C. Prakash
N1 - Funding Information:
Financial support: This study was partially funded through NIH/ NIDDK (T32 DK007130: Amit Patel; NIH K23DK84413-4: Gregory S Sayuk), and through the Washington University Department of Medicine Mentors in Medicine (MIM) and Clinical Science Training and Research (CSTAR) programs.
Publisher Copyright:
©2018 The Korean Society of Neurogastroenterology and Motility.
PY - 2018
Y1 - 2018
N2 - Background/Aims Breaks in the peristaltic contour on esophageal high-resolution manometry (HRM) may be associated with bolus retention in the esophagus. We evaluated the relationship between peristaltic breaks and esophageal symptoms, reflux exposure, and symptom outcomes in a prospective patient cohort. Methods Two hundred and eighteen patients (53.2 ± 0.9 years, 68.3% female) undergoing both pH-impedance testing and HRM over a 5-year period were prospectively evaluated. Demographics, symptom presentation, acid exposure time, symptom association probability, and symptom burden scores were collected. Outcomes were assessed on follow-up using changes in symptom scores. Presence of long breaks (≥ 5 cm) on HRM was assessed by a blinded author. Relationships between breaks, reflux parameters, presenting symptoms, and outcomes were assessed. Results Patients with long breaks were more likely to have cough as a presenting symptom than those without (43.4% vs 28.6%, P = 0.024); statistical differences were not demonstrated with other symptoms (P ≥ 0.3). Numbers of swallows with long breaks were higher in patients with cough compared to those without (2.4 ± 0.3 vs 1.6 ± 0.2, P = 0.021); differences were not found with other symptoms (P ≥ 0.4). Long breaks were not associated with age, gender, race, reflux burden, symptom association, or changes in symptom metrics (P ≥ 0.1 for all comparisons). Among patients with cough, the presence of long breaks predicted suboptimal symptom improvement with antireflux therapy (P = 0.018); this difference did not hold true for other symptoms (P ≥ 0.2). Conclusions Long breaks in esophageal peristaltic integrity are associated with cough. The presence of long breaks is associated with suboptimal benefit from antireflux therapy.
AB - Background/Aims Breaks in the peristaltic contour on esophageal high-resolution manometry (HRM) may be associated with bolus retention in the esophagus. We evaluated the relationship between peristaltic breaks and esophageal symptoms, reflux exposure, and symptom outcomes in a prospective patient cohort. Methods Two hundred and eighteen patients (53.2 ± 0.9 years, 68.3% female) undergoing both pH-impedance testing and HRM over a 5-year period were prospectively evaluated. Demographics, symptom presentation, acid exposure time, symptom association probability, and symptom burden scores were collected. Outcomes were assessed on follow-up using changes in symptom scores. Presence of long breaks (≥ 5 cm) on HRM was assessed by a blinded author. Relationships between breaks, reflux parameters, presenting symptoms, and outcomes were assessed. Results Patients with long breaks were more likely to have cough as a presenting symptom than those without (43.4% vs 28.6%, P = 0.024); statistical differences were not demonstrated with other symptoms (P ≥ 0.3). Numbers of swallows with long breaks were higher in patients with cough compared to those without (2.4 ± 0.3 vs 1.6 ± 0.2, P = 0.021); differences were not found with other symptoms (P ≥ 0.4). Long breaks were not associated with age, gender, race, reflux burden, symptom association, or changes in symptom metrics (P ≥ 0.1 for all comparisons). Among patients with cough, the presence of long breaks predicted suboptimal symptom improvement with antireflux therapy (P = 0.018); this difference did not hold true for other symptoms (P ≥ 0.2). Conclusions Long breaks in esophageal peristaltic integrity are associated with cough. The presence of long breaks is associated with suboptimal benefit from antireflux therapy.
KW - Cough
KW - Esophageal motility disorders
KW - Esophageal pH monitoring
KW - Gastroesophageal reflux
UR - http://www.scopus.com/inward/record.url?scp=85049382708&partnerID=8YFLogxK
U2 - 10.5056/jnm17126
DO - 10.5056/jnm17126
M3 - Article
C2 - 29969856
AN - SCOPUS:85049382708
VL - 24
SP - 387
EP - 394
JO - Journal of Neurogastroenterology and Motility
JF - Journal of Neurogastroenterology and Motility
SN - 2093-0879
IS - 3
ER -