Functional luminal imaging probe (FLIP) panometry offered superior detection of esophageal retention over integrated relaxation pressure (IRP) on high-resolution manometry (HRM). Researchers undertook the analysis for comparing HRM and FLIP panometry to predict esophageal retention on the timed barium esophagram (TBE).

The study incorporated 329 adult participants who completed HRM, FLIP, and TBE for primary esophageal motility assessment were incorporated. A one-minute column height >5 cm or the impaction of 12.5-mm barium tablet was defined as an abnormal TBE. The IRP on HRM was assessed in upright and supine patient positions.

Assessment of esophagogastric junction (EGJ) opening was done with 16-cm FLIP carried out during sedated endoscopy via maximum EGJ diameter and EGJ-distensibility index. The area under the curve (95% confidence interval) for supine IRP, upright IRP, EGJ-distensibility index, maximum EGJ diameter, as found from the receiver operating characteristic curves for identifying an abnormal TBE, is shown in Table 1: 

The logistic regression to anticipate abnormal TBE demonstrated an odds ratios of 39.7 (16.4-96.2) for reduced EGJ opening and 1.8 (0.84-3.7) for consistent IRP rise on the FLIP panometry.

Out of 40 participants having HRM-FLIP panometry discordance, FLIP panometry illustrated consistency with TBE in 78%. On the other hand, HRM-IRP showed consistency with TBE in 23%. But, application of a complementary assessment involving FLIP panometry, HRM, and TBE might be vital for accurately diagnosing esophageal motility disorders, concluded the study authors.