ISG Winter Meeting 2023

Poster Presentations
Second Prize

Lucy Quinlivan
Mercy University Hospital, Cork

Absent contractility: Consequence or cause of Supragastric Belching

TBA (23W116)

Absent contractility: Consequence or cause of Supragastric Belching.

Author(s)

Lucy Quinlivan, Julie O'Neill, Renu Singh, Michael Doyle, Ashley Lloyd, Gerard Forde, Martin Buckley

Department(s)/Institutions

GI Function Lab, Mercy University Hospital, Cork

Introduction

Absent contractility(AC) is a motility disorder characterised by 100% aperistalsis. In the GI Lab at the Mercy Hospital it has become apparent that AC occurs in a cohort of patients who present with supragastric belching(SGB), which is behavioural in nature.

Aims/Background

To examine the relationship between AC, SGB and acid reflux.

Method

High resolution impedance manometry(Manoscan, Given Imaging) reports(2018-2023) were examined, those that met the Chicago classification(v3.0 and 4.0) for AC were selected for this restrosepctive study,(N=22),(N=10 Male, N=12 Female). 24hr pHz and impedance data(sandhill, Diversatek)from patients with AC was examined and the threshold for excessive SGB was taken as >13 episodes/24 hrs. Data were analysed using ‘part of whole’ distribution and 95% confidence interval(CI) was exstablished using Prism, Graphpad.

Results

Excessive SGB was evident in 82% of patients with AC(95% CI: 60-95%). Normal DeMeester score(<14.7/24hrs) was evident in 50% of patients with AC and SGB(95% CI: 26-74%). Normal acid exposure time(<4.2%/24hrs) was evident in 67% of patients with AC and SGB(95% CI: 41%-87%). Normal total number of reflux episodes(<73/24hrs) was evident in 44% of patients with AC and SGB(95% CI: 21-69%).

Conclusions

This study identifies a cohort of patients in which AC is linked with SGB. This raises the question as to whether SGB is a consequence or cause of AC. It is possible that SGB is a subconscious reflex used to attempt oesophageal clearance. Future studies should extend these findings to determine whether the current therapeutic treatment of SGB with diaphragmatic breathing is sufficient to improve oesophageal motility in patients with AC

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