STUDY OF OESOPHAGEAL MOTILITY AND GASTRO­ OESOPHAGEAL REFLUX AFTER ENDOSCOPIC INJECTION SCLEROTHERAPY .•

Abstract

The effect of endoscopic injection sclerotherapy .(EIS) of oesophageal varices on oesophageal motility and gastro-oesophageal reflux was studied. Distal oesophageal manometry and 24-hour ambulatory pH monitoring were performed to 15 patients who underwent EIS (group IV), 16 patients with oesophageal varices without prior endoscopic treatment (group Ill), 11 patients with gastro-oesophageal reflux disease {group II) and 9 healthy subjects (group I). lower oesophageal sphincter resting pressure {LOSRP) was significantly lower in group IV compared with groups I and III. Peristaltic contractions were significantly less prevalent in group IV compared with group I. Mean amplitude (MA) of peristaltic contractions was significantly lower in group IV •compared with group III in the middle channel. Mean duration (MD) of peristaltic contractions was significantly longer in group IV compared with group I in all channels and compared with group Ill in the distal channel. The number of multi-peaked peristaltic contractions was significantly higher in group IV compared with the other 3 groups in distal as well as M&D channels. Patients of group IV with persistent dysphagia had significantly lower LOSRP as well as percentage of peristaltic contractions and significantly higher percentage of low­ amplitude contractions than those without. Patients of group IV with symptoms (dysphagia, heartburn and/or epigastric discomfort) had significantly lower LOSRP and MA of peristaltic contractions in both distal and M&D channels, and significantly higher occurrence of pathological acid reflux than those without symptoms. MD of peristaltic contractions was significantly longer in patients with a number of sclerotherapy sessions ;, 7 in both middle and M&D channels compared with those with a number < 7. Also, a positive correlation was found between the number of sclerotherapy sessions and MD of peristaltic contractions in the middle channel. In spite of the significant distal oesophageal motility dysfunction found in group IV patients, no significant differences in all parameters of pathological acid reflux were found between group IV and groups Iand Ill.