Tags

Type your tag names separated by a space and hit enter

Esophageal motility abnormalities in cirrhotic patients before and after endoscopic variceal treatment.
Am J Gastroenterol. 1997 Jun; 92(6):941-6.AJ

Abstract

Esophageal motility abnormalities in patients treated endoscopically for variceal hemorrhage are rarely studied and usually are not addressed in the clinical setting. However, a review of the literature revealed that esophageal varices reduce the mean amplitude and increase the mean duration of peristaltic waves but have little effect on lower esophageal sphincter function. Transit time is delayed and gastroesophageal reflux disease is common in up to 64% of the patients. Whereas band ligation appears to have little impact on esophageal motility, data are limited and are hampered by lack of standardization, rendering conclusions about safety rather premature. Injection sclerotherapy spares the lower esophageal sphincter, as well, but it significantly reduces mean amplitude contractions, mainly in the lower one-third to one-half of the esophagus. In addition, normal peristalsis may be occasionally or completely replaced by nonpropagating simultaneous contractions that may result in chest pain and/or dysphagia in the absence of stricture. Transient prolongation of acid clearance usually resolves within a week, except in patients who have developed stricture. Pathogenesis of the abnormal motility remains poorly understood, and treatment has been empirical. However, a short course of anti-reflux treatment after each therapeutic session is justified, as well as long-term treatment for patients with stricture. The choice of treatment for esophageal motility abnormalities is less clear and requires future studies.

Authors+Show Affiliations

Department of Medicine, University of Arizona Health Sciences Center and Tucson Veterans Affairs Medical Center, 85723, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

9177506

Citation

Fass, R, et al. "Esophageal Motility Abnormalities in Cirrhotic Patients Before and After Endoscopic Variceal Treatment." The American Journal of Gastroenterology, vol. 92, no. 6, 1997, pp. 941-6.
Fass R, Landau O, Kovacs TO, et al. Esophageal motility abnormalities in cirrhotic patients before and after endoscopic variceal treatment. Am J Gastroenterol. 1997;92(6):941-6.
Fass, R., Landau, O., Kovacs, T. O., & Ippoliti, A. F. (1997). Esophageal motility abnormalities in cirrhotic patients before and after endoscopic variceal treatment. The American Journal of Gastroenterology, 92(6), 941-6.
Fass R, et al. Esophageal Motility Abnormalities in Cirrhotic Patients Before and After Endoscopic Variceal Treatment. Am J Gastroenterol. 1997;92(6):941-6. PubMed PMID: 9177506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Esophageal motility abnormalities in cirrhotic patients before and after endoscopic variceal treatment. AU - Fass,R, AU - Landau,O, AU - Kovacs,T O, AU - Ippoliti,A F, PY - 1997/6/1/pubmed PY - 1997/6/1/medline PY - 1997/6/1/entrez SP - 941 EP - 6 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 92 IS - 6 N2 - Esophageal motility abnormalities in patients treated endoscopically for variceal hemorrhage are rarely studied and usually are not addressed in the clinical setting. However, a review of the literature revealed that esophageal varices reduce the mean amplitude and increase the mean duration of peristaltic waves but have little effect on lower esophageal sphincter function. Transit time is delayed and gastroesophageal reflux disease is common in up to 64% of the patients. Whereas band ligation appears to have little impact on esophageal motility, data are limited and are hampered by lack of standardization, rendering conclusions about safety rather premature. Injection sclerotherapy spares the lower esophageal sphincter, as well, but it significantly reduces mean amplitude contractions, mainly in the lower one-third to one-half of the esophagus. In addition, normal peristalsis may be occasionally or completely replaced by nonpropagating simultaneous contractions that may result in chest pain and/or dysphagia in the absence of stricture. Transient prolongation of acid clearance usually resolves within a week, except in patients who have developed stricture. Pathogenesis of the abnormal motility remains poorly understood, and treatment has been empirical. However, a short course of anti-reflux treatment after each therapeutic session is justified, as well as long-term treatment for patients with stricture. The choice of treatment for esophageal motility abnormalities is less clear and requires future studies. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9177506/Esophageal_motility_abnormalities_in_cirrhotic_patients_before_and_after_endoscopic_variceal_treatment_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -