Turkish Journal of Gastroenterology
Original Article

Changes in pressure waves after endoscopic intervention in patients with achalasia: A focus on peristaltic recovery of the esophageal body

1.

Department of Internal Medicine, Digestive Disease Center and Research Institute, Soonchunhyang University College of Medicine, Bucheon, Korea

Turk J Gastroenterol 2016; 27: 4-9
DOI: 10.5152/tjg.2015.150271
Read: 1051 Downloads: 453 Published: 25 July 2019

Abstract

Background/Aims: We conducted the present study to investigate the recovery of peristalsis of the esophageal body and evaluate the pressure changes observed on manometry before and after endoscopic intervention.

 

Materials and Methods: Forty-five patients were diagnosed with achalasia, and 36 received endoscopic or surgical treatment. We collected the data of 24 patients who underwent manometry before and after treatment (pneumatic balloon dilatation, n=7; botulinum toxin injection, n=10; peroral endoscopic myotomy, n=7).

 

Results: The lower esophageal sphincter (LES) resting pressure and nadir LES relaxation pressure decreased regardless of the achalasia subtype or type of endoscopic intervention following treatment (p<0.05). Among patients with a nadir LES relaxation pressure of <4 mmHg, 42.9% (6/14) exhibited partial esophageal peristaltic wave recovery. However, no patients with a nadir LES relaxation pressure of >4 mmHg exhibited peristaltic wave recovery (p=0.024). Of the six patients with peristaltic wave recovery, two had type I achalasia (15.4%), three had type II (33.3%), and one had type III (100.0%). The Eckardt score, symptom duration, and type of intervention were not associated with the recovery of peristaltic waves.

 

Conclusion: Our results suggest that normalization of the nadir LES relaxation pressure can be a predictive factor for the recovery of esophageal peristalsis.

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EISSN 2148-5607