The value of simple tests for peristaltic activity in hiatus hernia.

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) increased tone. A practical modification of this investigation subsequently reported (Donner, Silbiger, Hookman, and Hendrix, 1966) demonstrated that if barium is acidified (pH 1 7) cine-radiography showed aperistalsis, non-peristaltic contraction, or delayed emptying in 98-7% of patients with heartburn. This was proposed as a single test for detection of peptic oesophagitis. The present survey was undertaken to evaluate further the use of acidified barium in the diagnosis of oesophageal lesions.