Histologic and Manometric Studies on the Esophagus Following Endoscopic Sclerotherapy

Abstract

It appears that EST causes persistent manometric abnormalities and chronic inflammatory changes in the distal esophagus, the severity of which seems to vary directly with the frequency of sclerotherapy and not amount of sclerosant injected.

High-resolution Manometry Findings in Patients After Sclerotherapy for Esophageal Varices

“…[5][6][7] Our results showed a significant percentage of patients with hypotonic LES and a positive correlation between the number of sclerotherapy sessions and LES basal pressure. In fact, Sharma et al 13 showed not only the same results but also noticed that the degree of chronic inflammatory cell infiltrate and fibrosis parallels the number of sessions. There is no previous data on LES relaxation.…”

“…Previous reports focused on the alteration of esophageal motility after endoscopic therapy. [3][4][5][6][7][8][9][10][11][12][13] These studies, however, relied on conventional manometry for the evaluation. High-resolution manometry (HRM) is probably a more adequate tool to measure esophageal motility in these patients.…”

Treatment of Achalasia by Injection of Sclerosant Substances: A Long-Term Report

“…Although the esophagitis lesions were mild, their frequency and the high index of abnormal 24-h pH-metry readings (about 20 %) confirm the dysmotility secondary to EST. Previous studies on EST [5,22] confirm that EST with PD or EO for esophageal varices causes not only inflammatory changes in the distal esophagus but also dysmotility and GER.…”

“…More dilation procedures were required with PD, and EUS evidenced fibrosis in many of such patients. So, the number of procedures more than the amount of sclerosant injected would be related to fibrotic changes [5].…”

“…We report here our overall experience over a 20-year period with several aims: (1) to evaluate the long-term effectiveness of EST in achalasia; (2) to compare EO and PD as sclerosant agents; (3) to define the optimal schedule of treatment; (4) to evaluate the prognostic factors on undertaking the technique; (5) to define the potential role played by endoscopic ultrasonography (EUS); and (6) to evaluate the effectiveness of dilation when EST fails.…”