High‐resolution impedance manometry measurement of bolus flow time in achalasia and its correlation with dysphagia

Background We assessed whether a high‐resolution impedance manometry (HRIM) metric, bolus flow time (BFT) across the esophagogastric junction (EGJ), was abnormal in achalasia patients subtyped by the Chicago Classification and compared BFT to other HRM metrics. Methods HRIM studies were performed in 60 achalasia patients (14 type I, 36 type II and 10 type III) and 15 healthy controls. Studies were analyzed with a MATLAB program to calculate BFT using a virtual HRIM sleeve. Integrated relaxation pressure (IRP) and basal end‐expiratory EGJ pressure were also calculated. The relationship between BFT and dysphagia symptom scores was assessed using the impaction dysphagia questionnaire (IDQ). Key Results Median BFT was significantly lower in achalasia patients (0.5 s, range 0.0–3.5 s) compared to controls (3.5 s, range 2.0–5.0 s; p