Hypertensive lower esophageal sphincter (HLES): Prevalence,symptoms genesis and effect of pneumatic balloon dilatation

El-Hak, Nabil A Gad; Mostafa, Mohamed F.; Abdel-Hamid, Hussein; Haleem, Magdy

doi:10.4103/1319-3767.27850

Cited by 2 publications

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“…In our study population, impaired peristalsis, as assessed by manometry, was somewhat more frequent among patients with T2D. Moreover, dysphagia has been shown to be related to the presence of high LES pressure in patients with a hypertensive LES [22,23], which is also true for our investigation.…”

Section: Discussionsupporting

confidence: 66%

Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study

et al. 2013

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BackgroundInformation about gastro-oesophageal reflux disease (GERD) in patients with Diabetes mellitus type 2 (T2D) is scarce, although the incidence of both disorders is increasing.We aimed to determine GERD symptoms and their underlying pathophysiologic characteristics in T2D patients.MethodsThis “retro-pro” study compared 65 T2D patients to a control group of 130 age- and sex-matched non-diabetics. GERD was confirmed by gastroscopy, manometry, pH-metry and barium swallow.ResultsIn patients with T2D compared to controls, dysphagia (32.3% vs. 13.1%; p = 0.001) and globus sensation (27.7% vs. 13.8%; p = 0.021) were found more frequently, whereas heartburn (76.9% vs. 88.5%; p = 0.046) and regurgitation (47.7% vs. 72.3%; p = 0.001) were predominant in non-diabetics. Despite higher body mass indices (31.1 ± 5.2 vs. 27.7 ± 3.7 kg/m2; p < 0.001), hiatal hernia was less frequent in T2D patients compared to controls (60.0% vs. 90.8%, p < 0.001). Lower oesophageal sphincter (LES) pressure was higher in patients with T2D (median 10.0 vs. 7.2 mmHg, p = 0.016). DeMeester scores did not differ between the groups. Helicobacter pylori infections were more common in T2D patients (26.2% vs. 7.7%, p = 0.001). Barrett metaplasia (21.5% vs. 17.7%), as well as low- (10.8% vs. 3.8%) and high-grade dysplasia (1.5% vs. 0%) were predominant in T2D patients.ConclusionsT2D patients exhibit different GERD symptoms, higher LES pressures and a decreased prevalence of hiatal hernia than non-diabetics, which may be related to worse oesophageal motility and, thus, a more functional rather than anatomical cause of GERD. Low-grade dysplasia was more than twice as high in T2D than in non-diabetics patients.Trial registrationEthics committee of the Medical University of Vienna, IRB number 720/2011.

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Section: Discussionsupporting

confidence: 66%

Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study

et al. 2013

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“…The reported rates of these two findings range from 0 to 27% (4,15,19). The clinical sig-nificance, association with symptoms and appropriate management of these manometric findings have not been established (25). We had only three cases of DES (2.5%).…”

Section: Discussionmentioning

confidence: 96%

Esophageal Manometry Among Patients With Dysphagia Referred To Kurdistan Center For Gastroenterology And Hepatology

Mohammed¹,

Salim²,

Ramadhan³

2015

Adv.med.j.

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Background and Objectives:Dysphagia is a common problem in patients with primary motor disorders of the esophagus. Esophageal manom- etry is the gold standard for diagnosis of these disorders. Introduction of high resolution manometry represented a significant improvement in data recording and diagnostic yield. The objective of the study was to assess the findings of esophageal high resolution impedance manometry in patients presenting with dysphagia in Sulaimani governorate. Patients and Methods:This study extended from September, 2012 to December, 2013 and included 120 patients with dysphagia who were referred for manometry in Kurdistan Center for Gastroenterology and Hepatology (KCGH) in Sulaimani city. All patients underwent upper endoscopy to exclude mechanical and inflammatory causes of dysphagia then the high resolution impedance manometry was used with liquid and viscous swallows. Results:The mean age of the study population was 43 years. The female to male ratio was 1.5:1. The mean duration of dysphagia was 2 years. The most common esophageal motility abnormality was achalasia (N=44, 36.7%) followed by hypertensive LES (N=31, 25.8%), ineffective esophageal motility (N=9, 7.5%), hypotensive LES (N=5, 4.2%) and diffuse esophageal spasm (N=3, 2.5%). The high resolution impedance manometry was normal in 28 patients (23.3%). Of the 44 patients with achalasia, 15 patients (34%) had vigorous achalasia. Using Chica- go classification, the most common type of achalasia was type II (N=26, 59%) followed by type I (N=13, 29.6%) and then type III (N=5, 11.4%). Conclusions:Esophageal high resolution impedance manometry has an acceptable diagnostic yield in patients with dysphagia.The most common finding is achalasia. Further studies are recommended.

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Hypertensive lower esophageal sphincter (HLES): Prevalence,symptoms genesis and effect of pneumatic balloon dilatation

Abstract: It was concluded that the prevalence of HLES is around 1.6, in which dysphagia and chest pain are the usual presenting symptom, and that pneumatic balloon dilatation is very effective when properly applied. It will probably occupy the same position it has in achalasia.

Cited by 2 publications

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Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study

Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study

Esophageal Manometry Among Patients With Dysphagia Referred To Kurdistan Center For Gastroenterology And Hepatology

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