Does lower esophageal sphincter incompetency contribute to esophageal bleeding?
The purpose of this study is to determine whether lower esophageal sphincter (LES) incompetency is a common occurrence in patients with liver cirrhosis and contributes to the development of variceal bleeding. Resting LES pressure (17.8 +/- 1.1 mm Hg) in 35 patients with cirrhosis was similar to that of our control population (17.3 +/- 2.0 mm Hg). No differences were found among patients with ascites, variceal hemorrhage, or with different degrees of hepatic decompensation. In both patients and control subjects the LES responded with a significant pressure increase to gastric alkalinization. Symptoms and radiological evidence of gastroesophageal reflux were extremely uncommon in patients with liver cirrhosis. Based on these data it is unlikely that acid-pepsin regurgitation is a significant factor in the development of variceal hemorrhage.
D000328:Adult; D000368:Aged; D001201:Ascites / Q000150:complications; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000503:physiopathology*; D004942:Esophagitis, Peptic / Q000503:physiopathology; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005745:Gastric Acidity Determination; D005755:Gastrins / Q000097:blood; D005764:Gastroesophageal Reflux / Q000503:physiopathology; D006471:Gastrointestinal Hemorrhage / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008111:Liver Function Tests; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction
D005755:Gastrins