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The generation of esophageal symptoms while swallowing is a multifactorial phenomenon. Previous studies tried to analyze the correlation between objective esophageal functions using high-resolution manometry (HRM) and abnormal esophageal perceptions such as pain or dysphagia, but they were unable to verify the relationship between them. Recently, Xiao et al1 investigated whether new manometric metrics can show a relationship between symptoms and abnormal motor function while swallowing. HRM studies included 10 supine liquids, 5 upright liquids, 2 upright viscous and 2 upright solid swallows. All patients evaluated their esophageal symptoms for each upright swallow. Symptoms were graded on a 4-point likert score (0, none; 1, mild; 2, moderate; 3, severe). HRM metrics were compared between groups with and without symptoms during the upright liquid protocol. Of the 269 patients, 116 recorded symptoms during viscous or solid swallows. HRM metrics were similar between swallows with and without associated symptoms in the upright, viscous and solid swallows. No correlation was noted between the HRM metrics and the symptom scores among swallow types. Finally, they concluded that esophageal symptoms are not related to abnormal motor functions defined by HRM. Also, other factors beyond circular muscle contraction patterns should be explored as possible causes of symptom generation.
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