ESOPHAGEAL MOTILITY AND GASTROESOPHAGEAL REFLUX - EFFECT OF VARICEAL ERADICATION BY ENDOSCOPIC SCLEROTHERAPY

Endoscopic injection sclerotherapy (EIS) is known to produce oesophage al structural and motility changes; however, alterations in frequency and severity of gastro-oesophageal reflux (GER) following EIS have not been investigated in detail. We studied 22 patients with cirrhosis an d oesophageal varices before EIS and 26 after variceal eradication wit h intravariceal EIS using manometry and 24 h pH monitoring. The post-E IS group had reduced oesophageal sphincter pressure (19.2 +/- 11.4: vs 26.1, 16.4 mmHg, P < 0.05) and slower velocity of oesophageal perista lsis (2.47 +/- 0.71 vs 3.06 +/- 0.77 cm/s, P < 0.01) than the pre-EIS patients. There was no difference-in the amplitude or duration of the contraction. Abnormal contraction wave-forms were observed more freque ntly in post-EIS than in the pre-EIS patients (3/22 vs 12/26, P < 0.05 ). Various quantitative parameters for GER were not increased in post- EIS compared with pre-EIS patients. Abnormal GER was present in nine o f 21 pre-EIS and eight of 17 post-EIS patients (no significant differe nce). These results suggest that although persistent oesophageal motil ity changes are frequent after intravariceal EIS, these do not lead to a significant increase in GER.