Assessment of normal and symptomatic patients using the rapid pull- through technique of oesophageal manometry

Obervations on the effect of smoking on lower oesophageal sphincter pressure (LOSP) are based on station pull-through techniques of oesophageal manometry and recent studies have suggested that these techniques are inaccurate. Reproducible measurements of LOSP may be achieved with a rapid pull-through (RPT) method ofmanometry. This method was used to determine the effect of cigarette smoking on LOSP in 10 asymptomatic volunteers and in a group of 10 patients with symptoms of gastro-oesophageal reflux. Basal LOSP measurements in the two groups were not significantly different but LOSP was reduced by 19% in asymptomatic subjects (p <0-01) and by 21 % in symptomatic patients (p <0-02) during cigarette smoking. The results suggest that smoking should be avoided in the clinical management of gastro-oesophageal reflux.