| Incomplete lower esophageal sphincter relaxation in subjects with peristalsis: prevalence and clinical outcome. | |
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MedLine Citation:
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PMID: 2028954 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Incomplete lower esophageal sphincter relaxation is recognized in achalasia and has been reported in subjects with esophageal spasm. We reviewed 500 consecutive manometric studies from a 3-yr period to determine the prevalence of this manometric finding, its association with other motility abnormalities, and the clinical outcome of subjects without associated aperistalsis (i.e., without achalasia). We identified 60 subjects with incomplete lower sphincter relaxation, 17 of whom had at least some normal peristalsis (3.4% of the total). Mean lower sphincter residual pressure for these 17 subjects (4.5 +/- 2.8 mm Hg) was intermediate between those with achalasia (11.7 +/- 6.8 mm Hg) and those with normal relaxation (0.1 +/- 0.2 mm Hg). Both peristaltic and contraction abnormalities in the esophageal body were prevalent in the 17 subjects compared with those who had normal relaxation. Outcome with conservative medical therapy after a mean follow-up of 3.3 yr was not significantly related to presence of peristaltic or contraction abnormalities at presentation, and 71% of subjects with or without these concomitant findings had improvement or complete resolution of symptoms. Only one subject worsened and was treated with pneumatic dilation. We conclude that incomplete relaxation of the lower esophageal sphincter without aperistalsis is uncommon, symptom regression occurs with conservative therapy, and pneumatic dilation appears rarely required over a modest follow-up period. |
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Authors:
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G Aliperti; R E Clouse |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 86 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 1991 May |
Date Detail:
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Created Date: 1991-06-12 Completed Date: 1991-06-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 609-14 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analysis of Variance Esophageal Achalasia / epidemiology*, physiopathology*, therapy Esophagogastric Junction / physiopathology* Female Humans Male Manometry Peristalsis Pressure Prevalence Prognosis |
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