A NEW TECHNIQUE FOR MEASURING LOWER ESOPHAGEAL SPHINCTER COMPETENCE IN PATIENTS

Oesophageal sphincter measurements were carried out on 80 patients usi ng the stationary pull through technique; Normals (n=21), Nutcracker ( n=12), Refluxers (n=21), and Barrett's (n=26). Sphincter pressure (LOS P), abdominal length of sphincter, and overall sphincter length were m easured. The Sphincter Function Index (SFI) was calculated as the prod uct of sphincter pressure and percentage sphincter length (AL) exposed to abdominal pressure. Patients also had routine endoscopy and 24 hou r pHmetry. SFI values discriminated between all four groups. LOSP was significantly different for Barrett's (p<0.01) and Nutcracker (p<0.01) compared to normals. AL was significant for Refluxers (p<0.001) and B arrett's (p<0.001) compared to normals. SFI gives better discriminatio n than LOSP or AL alone and may be useful in evaluating the response t o treatment.