HIGHLIGHTS
•The current definition for hypercontractile esophagus was arbitrarily set at the uppermost range in volunteers for a specific equipment.
•4000 mmHg.cm.s sems to be a more reasonable cutoff value.
•The lack of a gold standard test or symptoms prevent a perfect definition.
ABSTRACT
Background:
The current definition for hypercontractile esophagus was arbitrarily set at the uppermost range in volunteers for a specific equipment.
Objective:
This study aims to critically analyze the concept of hypercontractile waves to redefine hypercontractile esophagus parameters.
Methods:
We reviewed 500 unselected and consecutive HRM tests (5000 waves) performed in a water -perfused system.
Results:
Mean distal contractility integral (DCI) was 825±1492 (0-42775) mmHg.cm.s, two standard deviations above average = 3810; 95th percentile = 2798 mmHg.cm.s.
Conclusion:
In healthy volunteers, two standard deviations above average is 4000 mmHg.cm.s, we thus suggest this value to define hypercontractile waves and define hypercontractile esophagus in a water-perfused HRM system.
Keywords:
Esophageal motility disorders; hypercontractile esophagus; high resolution manometry; distal contractile integral
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