The value of simple tests for peristaltic activity in hiatus hernia

A study has been made of oesophiageal peristaltic activity as viewed at barium swallows, in an effort to see whether this is helpful in assessing the type and degree of oesophageal lesions associated with hiatus hernia. It has not been possilble to establish a clinical usefulness from such testing as the frequency with which peristaltic upset occurs is too marginal. Siegel and Hendrix (1963) showed that all patients with heartburn developed symptoms with acid perfusion of the oesophagus. Manometric studies performed during perfusion demonstrated one of the following types of motor abnormality: (1) increased amplitude and duration of peristalsis; (2) spastic non-peristaltic contraction; and (3) in-creased tone. A practical modification of this investigation subsequently reported (Donner, Silbiger, Hook-man, and Hendrix, 1966) demonstrated that i