Esophageal Function after Sclerotherapy of Bleeding Varices

Abstract

To study the effect of sclerotherapy of varices on esophageal function, the motility of the tubular esophagus and of the lower esophageal sphincter (LES) were recorded in 19 patients after 7 to 13 sclerotherapy sessions and in 15 healthy volunteers. In addition, esophageal functional scintigraphy (EFS) was performed in the patient group. Compared with the volunteers the patients had lower contraction amplitudes in the distal esophagus (30.5 ± 17.5 mm Hg versus 43.6 ± 9.1 mm Hg, p < 0.01) and a higher percentage of non-propulsive simultaneous contractions (NPC) in the distal (33.4 ± 23.2% versus 9.0 ± 8.6%, p < 0.005) and mid-esophagus (15.0 ± 8.2% versus 8.3 ± 8.1%, p < 0.05). There was a negative correlation between the percentage of NPC in the distal and mid-esophagus and radionuclide transit (r, −0.53. p < 0.02). Three of 19 patients had a positive reflux index by EFS. The LES tone was only slightly lower in the patients than in the controls (10.7 ± 3.2 mm Hg versus 13.4 ± 3.6 mm Hg, p < 0.05). Our findings indicate that sclerotherapy of esophageal varices may lead to a reduced peristaltic esophageal motility with an impaired transport function. This could contribute to the development of dysphagia or esophagitis.

Key-words:

• Esophageal manometry
• esophageal radionuclide transit
• sclerotherapy of esophageal varices