Compliance measurement of lower esophageal sphincter and esophageal body in achalasia and gastroesophageal reflux disease

Little is known about the effect of achalasia and gastroesophageal reflux d isease (GERD) on compliance of the esophageal body and the lower esophageal sphincter (LES). Twenty-two patients with achalasia, 14 with GERD, and 14 asymptomatic volunteers were assessed. Recording apparatus consisted of a s pecially developed PVC bag tied to a compliance catheter, a barostat, and a polygraph. Intrabag pressures were increased incrementally while the bag v olume was recorded. In each subject, pressure-volume graphs were constructe d for both the esophageal body and LES and the compliance calculated. In ac halasia, compliance of the esophageal body was significantly higher (P < 0. 01) than in controls, whereas LES compliance was similar. Patients with GER D had a highly compliant LES in comparison to both controls and to patients with achalasia (P < 0.01 and P < 0.001, respectively); however there was n o difference in their esophageal body compliance. In conclusion, foregut mo tility disorders can cause changes in organ compliance that are detectable using a barostat and a suitably designed compliance bag. Further measuremen t of compliance may provide clues to the pathogenesis of these disorders.