[Esophageal motor disorders in cirrhotic patients with esophageal varices non-submitted to endoscopic treatment].
BACKGROUND
The hepatic cirrhosis has as one of the main morbid-mortality causes, the portal hypertension with the development of esophageal varices, the possibility of a digestive hemorrhage and worsening of hepatic insufficiency. It is important to identify causal predictive or aggravating factors and if possible to prevent them. In the last years, it has been observed the association of esophageal motor disorders and gastro-esophageal reflux in cirrhotic patients with esophageal varices.


OBJECTIVE
To study the prevalence of the esophageal motility disorders and among them, the ineffective esophageal motility, in patients with hepatic cirrhosis and esophageal varices, without previous endoscopic therapeutic and the predictive factors.


METHODS
Prospectively, it has been evaluate 74 patients suffering from liver cirrhosis and esophagic varices, without previous endoscopic treatment. All of them were submitted to a clinical protocol, esophageal manometry and 55 patients also held the ambulatory esophageal pHmetry.


RESULTS
Esophageal motility disorders have been found in 44 patients (60%). The most prevalent was the ineffective esophageal motility, observed in 28%. The abnormal reflux disease was diagnosed through the pHmetry in 35% of the patients. There were no correlation between the manometrical abnormality in general and the ineffective esophageal motility in particular and the esophageal or gastroesophageal reflux disease symptoms, the abnormal reflux, the disease seriousness, the ascites presence and the gauge of the varices.


CONCLUSIONS
The majority of cirrhotic patients with non-treated esophageal varices present esophageal motor disorders. No predictive factor was found. The clinical relevance of these findings need more researches in the scope to define the real meaning of theses abnormalities.
Flores
Priscila Pollo
PP
Serviço de Gastroenterologia, Hospital Clementino Fraga Filho, Rio de Janeiro, RJ.
Lemme
Eponina Maria de Oliveira
EM
Coelho
Henrique Sérgio Moraes
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000209:etiology*; D004932:Esophageal and Gastric Varices / Q000150:complications*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index