Esophageal motility changes after endoscopic intravariceal sclerotherapy with absolute alcohol

Endoscopic sclerotherapy (EST) leads to structural and motility changes in the esophagus; the former are thought to be commoner after EST with absolut e alcohol (AA), which is a commonly used sclerosant in India as it is cheap and effective. There are no previous studies on changes in esophageal moti lity after EST with AA. Accordingly, we studied patients with portal hypert ension before (n = 24) and after (n = 22) variceal obliteration by EST with AA using a water perfusion esophageal manometry system. Contraction amplit ude in the distal esophagus was reduced in the post-EST group compared with the pre-EST group (63.4 +/- 24.9 vs. 18.2 +/- 14.3 mmHg, p < 0.01). Durati on of esophageal contraction in both the proximal and distal esophagus beca me prolonged in the post-EST compared with the pre-EST group (3.3 +/- 0.8 v s. 5.4 +/- 2.6 and 4.3 +/- 1.1 vs. 6.6 +/- 2.3 s, p < 0.001 for both). Lowe r esophageal sphincter (LES) pressure was reduced in the post-EST compared with the pre-EST group, although the difference was not significant statist ically. Abnormal contraction waveforms were more frequent in the post-EST g roup. One patient in the post-EST group had persistent dysphagia in the abs ence of endoscopically documented stricture at the time of manometric study . This study shows frequent occurrence of esophageal dysmotility after EST with AA; however, esophageal dysmotility after EST was infrequently associa ted with motor dysphagia.