The role of high resolution oesophageal manometry in occult respiratory symptoms

• Published in: Respiratory medicine Vol. 138; pp. 47 - 49
• Main Authors: Burke, Jennifer M., Jackson, Warren, Morice, Alyn H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2018; Elsevier Limited
• Subjects: Abdomen; Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Chronic Disease; Cough; Cough - etiology; Cough - physiopathology; Dyspepsia; Dyspepsia - complications; Esophageal Motility Disorders - complications; Esophageal Motility Disorders - physiopathology; Esophagogastric Junction - physiopathology; Esophagus; Female; Females; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - physiopathology; High resolution; Humans; Hypersensitivity; Inhalation - physiology; Inspiration; Male; Males; Manometry; Manometry - methods; Middle Aged; Motility; Patients; Physiology; Pressure; Respiration; Respiratory diseases; Respiratory hypersensitivity; Respiratory Hypersensitivity - etiology; Respiratory Hypersensitivity - physiopathology; Young Adult; United Kingdom > UK; Switzerland; Netherlands; Manometry; Cough; Respiratory hypersensitivity
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2018.03.027

Cough Hypersensitivity Syndrome is the urge to cough following minimal stimulation, but its mechanism and method of provocation remain unexplained. 121 patients (44 males, 77 females; age range 18–81 years) were evaluated. High resolution manometry was performed on consecutive patients presenting with unexplained respiratory symptoms (Respiratory Group 61). Data were compared with matched controls, i.e. dyspepsia without respiratory symptoms (Dyspepsia Group 60). Results showed increased inspiratory gastro-oesophageal pressure gradient due to significantly lower intra-oesophageal pressure on inspiration (p = 0.001), and reduced oesophageal motility in the Respiratory Group. Further research in respiratory conditions characterised by decreased intrathoracic pressure during inspiration is needed. •Oesophageal manometry (HROM) shows dysmotility is common in respiratory disease.•Greater trans-diaphragmatic pressure is present compared with GORD controls.•Lower acid exposure suggests predominantly non-acid “airway reflux”.•HROM should be performed in patients with unexplained respiratory symptoms.