Reversible achalasia-like motor pattern of esophageal body secondary to postoperative stricture of gastroesophageal junction

Parrilla, Pascual; Aguayo, José Luis; Haro, L. Martinez De; Ortiz, Alberto; Martínez, Domingo Antonio Sánchez; Morales, G.

doi:10.1007/bf01299876

Cited by 15 publications

(6 citation statements)

References 11 publications

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“…With respect to the effect of treatment on tonic activity, it is possible that the post-treatment fall in gastro-oesophageal junction resistance and consequent “decompression” of the oesophagus could facilitate recovery of oesophageal tone and compliance. Since a hypercompliant oesophagus pretreatment and the resulting “common cavity” effect may be responsible for the manometric appearance of aperistalsis,22 recovery of tone post-treatment could explain the reappearance of peristaltic activity, as observed in some patients. Nevertheless, in our study oesophageal basal tone and compliance remained unchanged one month after treatment.…”

Section: Discussionmentioning

confidence: 99%

Oesophageal tone in patients with achalasia

González

Mearin

Vásconez

et al. 1997

Gut

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Background-The diagnosis and classification of oesophageal motility disorders is currently based on assessment of the phasic contractile activity of the oesophagus. Tonic muscular contraction of the oesophageal body (oesophageal tone) has not been well characterised. Aim-To quantify oesophageal tonic activity in healthy subjects and in patients with achalasia. Patients-Oesophageal tone was measured in 14 patients with untreated achalasia and in 14 healthy subjects. In eight patients with achalasia, oesophageal tone was again measured one month after either endoscopic or surgical treatment. Methods-Tonic wall activity was quantified by means of a flaccid intraoesophageal bag, 5 cm long and of 120 ml maximal capacity, which was placed and maintained 5 cm above the lower oesophageal sphincter and connected to an external electronic barostat. The experimental design included measurement of oesophageal basal tone and compliance as well as the oesophageal tone response to a nitric oxide donor (0.5 ml amyl nitrite inhalation). Results-Oesophageal basal tone, expressed as the intrabag (intraoesophageal) volume at a minimal distending pressure (2 mm Hg), did not diVer significantly between patients with achalasia and healthy controls (6.6 (2.5) ml versus 4.1 (0.8) ml, respectively). Oesophageal compliance (volume/pressure relation during intraoesophageal distension) was significantly increased in achalasia (oesophageal extension ratio: 3.2 (0.4) ml/mm Hg versus 1.9 (0.2) ml/mm Hg; p< 0.01). Amyl nitrite inhalation induced oesophageal relaxation both in patients and in controls, but the magnitude of relaxation was greater in the latter (intrabag volume increase: 15.3 (2.4) ml versus 36.2 (7.1) ml; p<0.01). Conclusion-In patients with achalasia, oesophageal tonic activity, and not only phasic activity, is impaired. Although oesophageal compliance is increased, residual oesophageal tone is maintained so that a significant relaxant response may occur after pharmacological stimulation. (Gut 1997; 41: 291-296)

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Section: Discussionmentioning

confidence: 99%

Oesophageal tone in patients with achalasia

González

Mearin

Vásconez

et al. 1997

Gut

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“…[13][14][15][16][17] We hypothesize that prolonged obstruction at the level of the UES results in similar progressive dilation and weakness of the pharynx. The purpose of this investigation was to evaluate the association between UES obstruction and dilation and diminished contractility of the pharynx.…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal dilation in cricopharyngeus muscle dysfunction and Zenker diverticulum

et al. 2010

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“…Familial, infectious, and autoimmune factors may trigger the inflammatory process 2,8,9. Neuronal degeneration has also been proposed to be a possible etiologic factor 10-12. To date, studies on the pathophysiology and etiology of achalasia have been conducted using traditional laboratory tools.…”

Section: Discussionmentioning

confidence: 99%

Proteomic Identification of Proteins Suggestive of Immune-Mediated Response or Neuronal Degeneration in Serum of Achalasia Patients

Im¹,

Yeo²,

Lee³

2013

Gut Liver

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Background/AimsThe primary pathophysiologic abnormality in achalasia is known to be a loss of inhibitory myenteric ganglion cells, which may result from an immune-mediated response or neuronal degeneration. The aim of this study was to identify proteins suggestive of an immune-mediated response or neuronal degeneration in the serum of achalasia patients using a proteomic analysis.MethodsBlood samples were collected from five symptomatic achalasia patients and five sex- and age-matched healthy controls. Serum proteomic analysis was conducted, and the protein spots were identified using matrix-assisted laser desorption ionization/time-of-flight and a proteomics analyzer. The serum level of C3 was measured by enzyme-linked immunosorbent assay in nine patients with achalasia and 18 sex- and age-matched healthy controls.ResultsOf the 658 matched protein spots, 28 spots were up-regulated over 2-fold in the serum from achalasia patients compared with that from controls. The up-regulated proteins included complement C4B5, complement C3, cyclin-dependent kinase 5, transthyretin, and alpha 2 macroglobulin. The serum levels of C3 in achalasia patients were significantly higher than those of controls.ConclusionsThe serum proteomic analysis of achalasia patients suggests an immune-mediated response or neuronal degeneration. Further validation studies in larger samples and the esophageal tissue of achalasia patients are required.

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Reversible achalasia-like motor pattern of esophageal body secondary to postoperative stricture of gastroesophageal junction

Cited by 15 publications

References 11 publications

Oesophageal tone in patients with achalasia

Oesophageal tone in patients with achalasia

Pharyngeal dilation in cricopharyngeus muscle dysfunction and Zenker diverticulum

Proteomic Identification of Proteins Suggestive of Immune-Mediated Response or Neuronal Degeneration in Serum of Achalasia Patients

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