Provocative testing in patients with jackhammer esophagus : evidence for altered neural control

Jackhammer esophagus (JE) is a hypercontractile disorder, the pathogenesis of which is incompletely understood. Multiple rapid swallows (MRS) and rapid drink challenge (RDC) are complementary tests used during high resolution manometry (HRM) that evaluate inhibitory and excitatory neuromuscular function and latent obstruction respectively. Methods&aim. Our aim was to evaluate esophageal pathophysiology using MRS and RDC in 83 JE patients (28 males; 63; 54-70 years). Twenty one healthy subjects (11 males; 28; 26-30 years) were used as a control group. All patients underwent solid state HRM with ten 5 ml single swallows (SS) and one to three 10 ml MRS; 34 patients also underwent RDC. Data are shown as median-IQ range.