Dysmotility of the small intestine in achalasia

During recent years there has been increasing evidence for extraoesophageal dysfunction in achalasia. The aim was to investigate whether motility of t he small intestine is abnormal in achalasia. Thirteen patients (eight men, five women) aged 52 (33-85) years were studied. They had all previously und ergone treatment with pneumatic balloon dilatation acid were free of dyspha gia when examined. Ambulatory 24-h motility was recorded in the upper jejun um under standardized caloric intake with a digital datalogger and catheter -mounted pressure transducers located beyond the ligament of Treitz. Visual analysis was performed by two observers and data underwent quantitative an alysis of phasic contractile events using a computer program. Normal values were obtained from 50 healthy controls. In the fasting state, a complete l oss of cyclic MMC activity (n = 2), an abnormally prolonged phase II (n = 2 ) and disturbances in the aboral migration of phase III (n = 5) were ob ser ved, Postprandial motor response was absent (pl = 2) Or frequently showed a contraction frequency below the normal range (n = 5). Further abnormalitie s consisted in hypomotility during phase II (n = 3) and in a reduced freque ncy of migrating clustered contractions in the fasting (n = 2) or postprand ial state (n = 2). In addition, motor events not present in any healthy sub ject, giant migrating contractions (n = 5), retrograde clustered contractio ns (n = 6) and repetitive retrograde contractions (n = 3) were identified. Each patient exhibited findings out of the range of normal. Dysmotility of the proximal small intestine is present in achalasia.