Esophageal dysmotility in patients undergoing photodynamic therapy

Objective: To study the esophageal motility of patients with esophageal ade nocarcinoma or Barrett esophagus with high-grade dysplasia before and after photodynamic therapy. Patients and Methods: In this prospective study conducted between January 1 998 and October 1999, esophageal motility testing of the lower esophageal s phincter and esophageal body was performed with a water-perfused catheter, 2 days before and at least 3 weeks after patients underwent photodynamic th erapy for esophageal adenocarcinoma or Barrett esophagus. Results were classified as normal motility, ineffective esophageal motility , or aperistalsis. Results: Twenty-three patients were studied, 13 with car cinoma and 10 with Barrett esophagus. Overall, 11 patients (48%) had normal motility, 6 (26%) had ineffec tive esophageal motility, and 6 (26%) had ap eristalsis. Five patients with aperistalsis had carcinoma. Follow-up tracin gs after photodynamic therapy found that 6 patients (26%) had normal motili ty, 7 (30%) had ineffective esophageal motility, and 10 (43%) had aperistal sis. Conclusions: Esophageal dysmotility is common in patients with esophageal a denocarcinoma or Barrett esophagus. Photodynamic therapy may worsen esophag eal motility in some patients. Dysphagia after photodynamic therapy therefo re may be related to underlying esophageal dysmotility and may not always b e caused by stricture or underlying carcinoma.