title: Esophageal reflux before and after isolated myotomy for achalasia.
abstract: Four patients with achalasia underwent 24-hour esophageal pH measurements as ambulatory patients before and after limited myotomy without fundoplication. Resting lower esophageal sphincter pressure was reduced from 24.3 +/- 1.3 mm Hg to 7.5 +/- 4.3 mm Hg. No significant differences (p greater than 0.05) were found before and after operation in the total 24-hour pH data distribution (pH 6.24 +/- 0.84 vs 5.75 +/- 1.03), the fraction of time below pH 4.0 (4.8% +/- 5.3% vs 8.0% +/- 6.9%), or the mean duration of reflux episodes greater than 5 minutes (22.8 +/- 18.8 minutes vs 23.0 +/- 10 minutes), all +/- SD. Effective relief of esophageal obstruction in achalasia is feasible by isolated limited myotomy without producing gastroesophageal reflux.
authors.affiliation: Department of Medicine, St. Boniface General Hospital, Winnipeg, Manitoba, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Shoenut
authors.forename: J A
authors.initials: JA
authors.lastname: Wieler
authors.forename: A B
authors.initials: AB
authors.lastname: Micflikier
authors.forename: J M
authors.initials: JM
authors.lastname: Teskey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000150:complications / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period