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PubMed · 2756985

Lower esophageal sphincter dysfunction in diffuse esophageal spasm.

S Campo·M Traube
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Abstract

Although lower esophageal sphincter (LES) dysfunction has been reported in patients with diffuse esophageal spasm, recent changes in manometric criteria for spasm and for LES relaxation suggested a need for reassessment. Moreover, LES relaxation in reflux-associated spasm has not been reported previously. On clinical criteria and independent of manometric findings, 22 patients with spasm were assigned to either idiopathic (I-DES, N = 9) or reflux-associated spasm (R-DES, N = 13) groups. Patients who underwent manometry for chest pain (C-NL, N = 10) or reflux (R-NL, N = 10) and had normal peristalsis served as control groups. Percent LES relaxation was significantly reduced in both spasm groups, and R-DES had significantly lower percent relaxation than I-DES. Post-deglutitive nadir sphincter pressure was significantly greater in R-DES than in I-DES. Duration of relaxation was normal in I-DES, but was significantly decreased in R-DES. This study indicates that 1) LES relaxation may be impaired in I-DES patients meeting current criteria for spasm, 2) the impairment in I-DES is primarily in "amplitude" of relaxation, i.e., percent relaxation and nadir pressure, but not duration, 3) LES relaxation may also be impaired in R-DES, and 4) the impairment in R-DES is to a greater degree than in I-DES patients and may be seen in both "amplitude" and duration of relaxation. This study shows that there is a spectrum of sphincter dysfunction in patients with esophageal spasm. It also suggests that there may be separate mechanisms for LES relaxation in R-DES patients, one with impaired relaxation and the other with near complete relaxation, "transient" or otherwise, to allow for reflux.

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AdultAgedAged, 80 and overEsophageal Spasm, DiffuseEsophagogastric JunctionEsophagusFemaleGastroesophageal RefluxHumansMaleManometryMiddle AgedMuscle RelaxationPeristalsisJournal Article

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BibTeXRIS

S Campo, M Traube. 1989. Lower esophageal sphincter dysfunction in diffuse esophageal spasm.. https://pubmed.ncbi.nlm.nih.gov/2756985/

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