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From: christine.l.ayoub on 11 Jun 2007 14:20

Hi Howard,

Well, I've completed a second manometry (impedance), and 24 hour
impedance testing. I don't have the numbers yet, but I'll post them
when they come in. I also had a barium swallow and this is where my
question comes in. The radiologist said that everything looked very
normal; no signs of achalasia or motility problems. He did the thick
barium, fizzy stuff, tablet, and I drank barium while lying down. He
said everything moved into the esophagus normally. I asked the doctor
if a manometry shows poor motility, how can the barium swallow be
normal? He said he didn't know. As far as the second manometry, the
nurse told me that, again, it showed poor motility, but had low LES
pressures and no signs of incomplete LES relaxations. She said that
liquids moved very slowly through the esophagus. So, can you explain
the discrepancy?

Thanks!

Christine

From: Howard McCollister on 12 Jun 2007 12:54

<christine.l.ayoub(a)intel.com> wrote in message
news:1181586057.022147.43870(a)o11g2000prd.googlegroups.com...
>
> Hi Howard,
>
> Well, I've completed a second manometry (impedance), and 24 hour
> impedance testing. I don't have the numbers yet, but I'll post them
> when they come in. I also had a barium swallow and this is where my
> question comes in. The radiologist said that everything looked very
> normal; no signs of achalasia or motility problems. He did the thick
> barium, fizzy stuff, tablet, and I drank barium while lying down. He
> said everything moved into the esophagus normally. I asked the doctor
> if a manometry shows poor motility, how can the barium swallow be
> normal? He said he didn't know. As far as the second manometry, the
> nurse told me that, again, it showed poor motility, but had low LES
> pressures and no signs of incomplete LES relaxations. She said that
> liquids moved very slowly through the esophagus. So, can you explain
> the discrepancy?
>

Barium swallow is basically a pointless test in the workup of reflux
disease - low sensitivity AND low specificity. I would discount it as a
complete waste of your time and your insurance company's money. Why your
doctor would order both a repeat manometry AND a barium swallow baffles me.

HMc


From: christine.l.ayoub on 12 Jun 2007 15:43
Howard,

Maybe it's just me, but I can't open your post. You can send to my
private e-mail; I was very curious about your reply.

Thanks,
Christine

From: Howard McCollister on 12 Jun 2007 21:31

"Howard McCollister" <nospam(a)nospam.net> wrote in message
news:466ecf63$0$259$bb4e3ad8(a)newscene.com...
>
> <christine.l.ayoub(a)intel.com> wrote in message
> news:1181586057.022147.43870(a)o11g2000prd.googlegroups.com...
>>
>> Hi Howard,
>>
>> Well, I've completed a second manometry (impedance), and 24 hour
>> impedance testing. I don't have the numbers yet, but I'll post them
>> when they come in. I also had a barium swallow and this is where my
>> question comes in. The radiologist said that everything looked very
>> normal; no signs of achalasia or motility problems. He did the thick
>> barium, fizzy stuff, tablet, and I drank barium while lying down. He
>> said everything moved into the esophagus normally. I asked the doctor
>> if a manometry shows poor motility, how can the barium swallow be
>> normal? He said he didn't know. As far as the second manometry, the
>> nurse told me that, again, it showed poor motility, but had low LES
>> pressures and no signs of incomplete LES relaxations. She said that
>> liquids moved very slowly through the esophagus. So, can you explain
>> the discrepancy?
>>
>
> Barium swallow is basically a pointless test in the workup of reflux
> disease - low sensitivity AND low specificity. I would discount it as a
> complete waste of your time and your insurance company's money. Why your
> doctor would order both a repeat manometry AND a barium swallow baffles
> me.
>
> HMc
>


From: christine.l.ayoub on 13 Jun 2007 09:47
Howard,

Thanks for your reply! The reason why the Barium swallow was ordered
was because the first manometry indicated possible achalasia. There
was incomplete relaxation of the LES and poor esophageal motility.
The second manometry doesn't seem to show the incomplete relaxation of
the LES, but the motility is still poor. I don't have the official
report yet, that's what the nurse told me. I'm still hoping I'm a
candidate for surgery.

I'm thinking that if the docs here can't give me a clear diagnosis
soon, I'm going to consult with the Cleveland Clinic. I have the
ability to obtain insurance which lists the Cleveland Clinic as an 'in
network' provider. I hear they are one of the best for GI issues. If
you know of a better place, please let me know.

Christine

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