Objective: To compare lower esophageal sphincter (LES) measurements obtained with water-perfused manometry with a new solid-state technique.Normal values for LES resting pressure in suspected GERD (gastroesophageal reflux disease)-patients have been established using water-perfused manometry. These standard-values are also applied using new solid-state techniques, although they have never been compared before.
Methods: Thirty healthy subjects were studied twice on the same day: Technique 1: Station pull through using a water perfused catheter with ports arranged at 0, 90, 180 and 270 degrees which were averaged to give a mean LES pressure. Technique 2: Solid-state circumferential probe with a single station pull through. Data were collected using the same computer system and program. The LES pressures were randomly and blindly analyzed.Results:28 subjects of 30 were analyzed. Using the solid state system, the mean LES pressure was higher (26.6 vs. 21.7 mm Hg, p < 0.02) and 24 of 28 (85%) individual measurements were higher. The correlation between the two sets of measurements was also poor (r=0.54). Two subjects had a hypertensive LES by solid state (53.4 and 41.9 mm Hg) while their pressures were normal with water perfused manometry (19.4 and 23.4 mm Hg). The distal esophageal pressures (mean of pressure at 3 and 8 cm above LES) were the same with the two techniques.
Conclusions: In normal control subjects LES measurement using circumferential solid-state transducers yields higher pressures than standard water perfused manometric measurement. Which system yields the more accurate measurement of the physiologic LES remains to be determined.