Peer-reviewed article
Safety and Tolerability of High-Resolution Esophageal Manometry in Children and Adults
Janice Eunsoo Oh, Lizhou Huang, Will Takakura, Kevin Khuu, Jiajing Wang et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical safety study of high-resolution esophageal manometry (HRM), a diagnostic procedure for measuring swallowing function. The study examined 5,107 patients and found the procedure is safe and well-tolerated in 98.9% of cases. Children under 18 and adults over 80 were more likely to experience discomfort and unable to complete the procedure, though no serious complications occurred. The findings are intended to help doctors counsel patients considering this procedure.
Key points
- 98.9% of 5,107 patients tolerated HRM well with no serious complications
- Children under 18 years had a 5.77% intolerance rate, more than 5 times higher than adults aged 18-79 (0.99%)
- Adults aged 80 or older had a 2.43% intolerance rate
- Prior foregut surgery significantly increased intolerance risk (odds ratio 8.06)
- Race, sex, body mass index, and psychological or cognitive disorders did not significantly affect tolerance
Limitations
This study is a retrospective chart review of a single tertiary center and does not examine the underlying reasons why children and older adults experience discomfort during HRM. The study focuses on a medical procedure rather than child health outcomes or interventions to improve child well-being.
Abstract
INTRODUCTION: While high-resolution manometry (HRM) is widely accepted as a safe procedure, no study has assessed the safety profile of HRM in clinical practice. This study aimed to determine the safety and tolerability of HRM and to investigate potential determinants of intolerability. METHODS: We obtained HRM procedure reports, demographics, and clinical data (2005-2022) at a tertiary center using electronic chart review. Our primary outcome was HRM tolerability. Multivariable regression was performed to identify associations between the outcome and covariates including age, sex, race, and comorbidities. RESULTS: A total of 5,107 patients (60.3% female) were included. Of them, 5,050 patients (98.9%) tolerated HRM well and 57 patients (1.1%) did not. Age had a statistically significant effect on tolerance: those younger than 18 years had more than a 5-fold increase in not tolerating HRM compared with those aged 18-79 years (5.77% vs 0.99%; odds ratio [OR] = 5.44, 95% confidence interval [CI] 1.60-18.45; P = 0.007), and those aged 80 years or older were also more likely to terminate HRM (2.43% vs 0.99%; OR = 2.56, 95% CI 1.13-5.76; P = 0.024). While prior foregut surgery had a significant effect on tolerance (OR = 8.06, 95% CI 2.29-28.39; P = 0.001), other factors of race, sex, body mass index, and psychological or cognitive disorders had no significant impact. No serious complications were identified. DISCUSSION: HRM is safe and well-tolerated with approximately 1 in every 100 patients being unable to tolerate HRM. Intolerance was more commonly seen in children and seniors due to minor symptoms of discomfort without serious complications. These data points are crucial to counsel patients in whom HRM is being considered.