title: Compliance measurement of lower esophageal sphincter and esophageal body in achalasia and gastroesophageal reflux disease.
abstract: Little is known about the effect of achalasia and gastroesophageal reflux disease (GERD) on compliance of the esophageal body and the lower esophageal sphincter (LES). Twenty-two patients with achalasia, 14 with GERD, and 14 asymptomatic volunteers were assessed. Recording apparatus consisted of a specially developed PVC bag tied to a compliance catheter, a barostat, and a polygraph. Intrabag pressures were increased incrementally while the bag volume was recorded. In each subject, pressure-volume graphs were constructed for both the esophageal body and LES and the compliance calculated. In achalasia, compliance of the esophageal body was significantly higher (P < 0.01) than in controls, whereas LES compliance was similar. Patients with GERD had a highly compliant LES in comparison to both controls and to patients with achalasia (P < 0.01 and P < 0.001, respectively); however there was no difference in their esophageal body compliance. In conclusion, foregut motility disorders can cause changes in organ compliance that are detectable using a barostat and a suitably designed compliance bag. Further measurement of compliance may provide clues to the pathogenesis of these disorders.
authors.affiliation: Gastrointestinal Physiology Unit, St. Bartholomew's and the Royal London School of Medicine and Dentistry, The Royal London Hospital, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Jenkinson
authors.forename: S M
authors.initials: SM
authors.lastname: Scott
authors.forename: E
authors.initials: E
authors.lastname: Yazaki
authors.forename: G
authors.initials: G
authors.lastname: Fusai
authors.forename: S M
authors.initials: SM
authors.lastname: Walker
authors.forename: S S
authors.initials: SS
authors.lastname: Kadirkamanathan
authors.forename: D F
authors.initials: DF
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged