Esophageal Acid-Clearance and Motility after Endoscopic Sclerotherapy of Esophageal Varices |
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Authors: | H. Snady M. A. Korsten |
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Affiliation: | Section of Gastroenterology and Alcohol Research and Treatment Center, VA Medical Center, Bronx. New York and Mt. Sinai School of Medicine (CUNY) New York, New York |
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Abstract: | To investigate the possible mechanisms which may lead to esophageal strictures after endoscopic variceal sclerotherapy, we performed esophageal motility and acid-clearance studies before and after 24 sclerotherapy sessions in 10 patients. Comparing studies before and after sclerotherapy, we found: a 93% mean increase in the number of swallows required to clear a standard amount of administered acid 24 h after sclerotherapy. Acid clearance returned to baseline within 1 wk of sclerotherapy; minimal changes in esophageal motility, none of which was significant except for swallow-induced simultaneous contractions in the distal esophagus which were a prominent feature in manometric recordings within 24 h of sclerotherapy; no increase in acid reflux from the stomach. We conclude that acid clearance from the distal esophagus is markedly delayed for at least 24 h by sclerotherapy but that this defect in acid clearance is transient, lasting no more than 1 wk. The importance of this observation remains to be demonstrated, but it is consistent with the concept that acid-induced injury contributes to the formation of post-sclerotherapy strictures. |
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