The role of high resolution oesophageal manometry in occult respiratory symptoms

Highlights

• 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.

Abstract

Purpose

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.

Procedures

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).

Main findings

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.

Conclusions

Further research in respiratory conditions characterised by decreased intrathoracic pressure during inspiration is needed.