Esophageal dysmotility in patients undergoing photodynamic therapy.
OBJECTIVE
To study the esophageal motility of patients with esophageal adenocarcinoma or Barrett esophagus with high-grade dysplasia before and after photodynamic therapy.


METHODS
In this prospective study conducted between January 1998 and October 1999, esophageal motility testing of the lower esophageal sphincter and esophageal body was performed with a water-perfused catheter, 2 days before and at least 3 weeks after patients underwent photodynamic therapy for esophageal adenocarcinoma or Barrett esophagus. Results were classified as normal motility, ineffective esophageal motility, or aperistalsis.


RESULTS
Twenty-three patients were studied, 13 with carcinoma and 10 with Barrett esophagus. Overall, 11 patients (48%) had normal motility, 6 (26%) had ineffective esophageal motility, and 6 (26%) had aperistalsis. Five patients with aperistalsis had carcinoma. Follow-up tracings after photodynamic therapy found that 6 patients (26%) had normal motility, 7 (30%) had ineffective esophageal motility, and 10 (43%) had aperistalsis.


CONCLUSIONS
Esophageal dysmotility is common in patients with esophageal adenocarcinoma or Barrett esophagus. Photodynamic therapy may worsen esophageal motility in some patients. Dysphagia after photodynamic therapy therefore may be related to underlying esophageal dysmotility and may not always be caused by stricture or underlying carcinoma.
Malhi-Chowla
N
N
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Fla 32224, USA.
Wolfsen
H C
HC
DeVault
K R
KR
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000139:chemically induced* / Q000503:physiopathology*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects*; D011446:Prospective Studies