The Immediate Effect of Successful Pneumatic Dilatation on Esophageal Function in Achalasia

Abstract

In 10 patients with achalasia, successful pneumatic dilatation induced a predictable and significant reduction of elevated resting lower esophageal sphincter (LES) pressure. This weakened LES was still able to maintain an effective barrier against reflux after dilatation. In untreated achalasia, incomplete relaxation left a residual pressure at the LES indicating obstruction at this level during swallowing. After dilatation, this residual pressure was equal to normal, independently of resting LES pressure, and complete relaxation became an all or none response to swallowing. Elevated resting pressure in the body of the esophagus reverted to normal, but characteristic abnormal swallowing responses of this segment were not modified by pneumatic dilatation.

Key-words:

• Achalasia
• esophagus
• gastroesophageal sphincter
• lower esophageal sphincter
• motility
• pneumatic dilatation
• pressure measurements