A new method for the detection of incomplete lower esophageal sphincter relaxation in patients with achalasia.
BACKGROUND
In patients with early stages of achalasia manometry is of significant diagnostic value. Technically, however, measurement of lower esophageal sphincter (LES) relaxation is not always easy. Accordingly, we looked for a simpler way of measuring incomplete LES relaxation.


METHODS
In 186 consecutive patients referred to esophageal motility testing the esophageal body base-line pressure was measured during continuous swilling of 180 ml fluid within 20 sec.


RESULTS
Seventeen of the 186 patients had achalasia. Fourteen of these patients were compliant for the swill test, and all had a positive test, characterized by a steady increase in base-line pressure with negative deflections on deglutition. All nonachalasia patients could complete the test, which was negative in all except one patient, who had a severe peptic stricture.


CONCLUSIONS
The swill test is diagnostic for incomplete lower esophageal relaxation in achalasia in compliant patients without organic stenosis.
Funch-Jensen
P
P
Dept. of Surgical Gastroenterology L, Arhus University Hospital, University of Aarhus, Denmark.
Aksglaede
K
K
Thommesen
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003679:Deglutition; D004931:Esophageal Achalasia / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged
D003287:Contrast Media