Manometric evaluation of esophageal motility in patients submitted to prophylactic variceal sclerosis

Abstract

Sclerotherapy of esophageal varices is an effective hemostatic treatment and may also prevent bleeding. In our study, we examined the effects of prophylactic sclerotherapy on esophageal motility in 15 patients with Child's A cirrhosis of the liver. All the patients underwent three manometric measurements, performed respectively before the sclerotherapy, 1 week after the eradication of varices, and 3 months later. The results of our study show that prophylactic sclerotherapy of esophageal varices does not significantly change the resting pressure and length of the lower esophageal sphincter. Neither the amplitude nor the duration of the postswallowing esophageal peristaltic waves is significantly influenced by sclerotherapy. However, sclerotherapy produces a significant increase in tertiary contractions in the distal esophagus, which could explain the onset of dysphagia among patients in whom postsclerotherapy stricture is not evident.

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

“…Some authors noticed a decrease in pressure 3,10,13 while others did not show any changes. [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.…”

“…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.…”