Esophageal acid-clearance and motility after endoscopic sclerotherapy of esophageal varices.
To investigate the possible mechanisms which may lead to esophageal strictures after endoscopic variceal sclerotherapy, we performed esophageal motility and acid-clearance studies before and after 24 sclerotherapy sessions in 10 patients. Comparing studies before and after sclerotherapy, we found: a 93% mean increase in the number of swallows required to clear a standard amount of administered acid 24 h after sclerotherapy. Acid clearance returned to baseline within 1 wk of sclerotherapy; minimal changes in esophageal motility, none of which was significant except for swallow-induced simultaneous contractions in the distal esophagus which were a prominent feature in manometric recordings within 24 h of sclerotherapy; no increase in acid reflux from the stomach. We conclude that acid clearance from the distal esophagus is markedly delayed for at least 24 h by sclerotherapy but that this defect in acid clearance is transient, lasting no more than 1 wk. The importance of this observation remains to be demonstrated, but it is consistent with the concept that acid-induced injury contributes to the formation of post-sclerotherapy strictures.
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H
Snady
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MA
Korsten
D003679:Deglutition; D004940:Esophageal Stenosis / Q000209:etiology* / Q000503:physiopathology; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D004947:Esophagus / Q000502:physiology; D005336:Fiber Optic Technology; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use*
D012597:Sclerosing Solutions