ATYPICAL MANOMETRIC ABNORMALITY OF THE LOWER ESOPHAGEAL SPHINCTER - APROCEDURE-RELATED, STRESS-INDUCED PHENOMENON

Stress-induced esophageal contraction abnormalities have been well doc umented in the literature, but relatively little is known about stress -related lower esophageal sphincter(LES) dysfunction. Two patients are described in whom initial manometry studies revealed LES hypertension and impaired LES relaxation. Both patients were markedly anxious and agitated during the initial study. However, when the manometry was rep eated with the patients in a calmer state, LES pressure and function w ere normal. These cases demonstrate the need to be aware of stress-rel ated LES dysfunction. If this phenomenon is not identified in the appr opriate settings, it could lead to significant errors in management.