Lower oesophageal sphincter pressure and timed barium oesophagogram: two objective parameters in the non-invasive assessment of primary achalasia.
BACKGROUND
The non-invasive assessment of primary achalasia is not precise.


OBJECTIVE
To compare investigations before and 1 month after balloon dilation in achalasia.


METHODS
Fifty-two patients with primary achalasia were enrolled. Subjective and objective variables of oesophageal functions were analysed before and 1 month after balloon dilation.


RESULTS
The mean predilation symptom score, lower oesophageal sphincter pressure, height and volume of barium at 5 min were 7.7 +/- 2.6, 62.0 +/- 25.1 mmHg, 9.2 +/- 6.1 cm and 53.2 +/- 49.8 mL respectively; the mean postdilation values were 3.0 +/- 3.0, 34.1 +/- 12.5 mmHg, 7.9 +/- 5.1 cm and 28.0 +/- 30.1 mL respectively. The before dilation volume of barium at 5 min correlates significantly with lower oesophageal sphincter pressure (P < 0.01). The mean symptom scores, lower oesophageal sphincter pressure and volume of barium at 5 min dropped significantly after intervention (P < 0.01), but the reduction in barium height at 5 min was not significant. The percentage changes in volume at 5 min significantly predicted the percentage changes in lower oesophageal sphincter pressure (P < 0.01).


CONCLUSIONS
The volume of barium retention at 5 min can predict the lower oesophageal sphincter pressure before and after balloon dilation in primary achalasia. This could be used as a non-invasive objective tool for initial and post-dilation assessment.
Montazeri
G
G
Gastroenterology and Hepatology, Digestive Disease Research Center, Tehran University of Medical Science, Shariati Hospital, Tehran, Iran. montazer@ams.ac.ir
Nouri
N
N
Estakhri
A
A
Shirani
S
S
Derakhshan
M H
MH
Yaghoobi
M
M
Mikaeli
J
J
Malekzadeh
R
R
D000328:Adult; D001466:Barium Sulfate; D002404:Catheterization; D003287:Contrast Media; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015588:Observer Variation; D011312:Pressure; D011859:Radiography; D016896:Treatment Outcome
D003287:Contrast Media; D001466:Barium Sulfate