Gallbladder function and gastric liquid emptying in achalasia.
Because of evidence that the abnormalities in achalasia are not restricted to the distal esophagus, we investigated gallbladder function by cholescintigraphy in the steady state and in response to CCK and the scintigraphic gastric emptying of a liquid caloric meal in 10 individuals with achalasia and 10 normal controls. No abnormalities were found during the filling phase of the gallbladder but seven of the 10 patients showed a 50% reduction in the ejection fraction (39.4% +/- 30.4 vs 80.3 +/- 8.3 of controls, mean +/- SD, P = 0.007) and a slower than normal ejection phase (9.1%/min +/- 6.6 vs 18.1 +/- 4.5, P = 0.02. In eight of the 10 patients, gastric liquid emptying was accelerated with a T1/2 of 41.5 min +/- 15.4 vs 74.7 min +/- 11.5 in the controls (P = 0.007). It is concluded that in some achalasia patients extraesophageal functional abnormalities of the gastrointestinal tract may be found. Whether these findings are promoted by degenerative charges of extraesophageal nerve fibers as well as their clinical significance require further investigations.
Annese
V
V
Department of Gastroenterology, C.S.S. Hospital, San Giovanni Rotondo (FG), Italy.
Caruso
N
N
Accadia
L
L
Gabbrielli
A
A
Modoni
S
S
Frusciante
V
V
Federici
T
T
D002766:Cholecystokinin; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D007098:Imino Acids; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid
D007098:Imino Acids; D015609:Organotechnetium Compounds; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid; D002766:Cholecystokinin