Document Detail

Quantitative assessment of the response to therapy in achalasia of the cardia.
MedLine Citation:
PMID:  2753399     Owner:  NLM     Status:  MEDLINE    
Radionuclide oesophageal transit studies and manometry have been carried out in 15 patients with achalasia of the cardia, before treatment, after a course of nifedipine and after pneumatic bag dilatation. Transit studies were also done in 10 patients after cardiomyotomy and in 10 normal subjects. Images were recorded with the subjects seated in front of a gamma camera while swallowing a 10 ml bolus of 99Tcm-tin colloid and then after a further drink of 50 ml water. There was marked retention of tracer in the oesophagus in patients with achalasia compared with rapid clearance in control subjects. Bag dilatation significantly reduced lower oesophageal sphincter pressure but there was no significant difference in the 50% clearance time or percentage dose retained at 100s before and after the treatments. Oesophageal clearance of tracer after the additional drink of water, was improved by bag dilatation. Oesophageal transit in the patients after cardiomyotomy was similar to that in patients who had undergone bag dilatation. There was considerable retention of the tracer in the oesophagus overnight, but this did not result in pulmonary aspiration. Radionuclide oesophageal transit studies provided a quantitative assessment of therapy in achalasia and the proportion of tracer retained after the additional drink proved to be a sensitive measure of response to treatment. Nifedipine proved ineffective as a treatment for achalasia. Bag dilatation and cardiomyotomy were of similar value.
C S Robertson; J G Hardy; M Atkinson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gut     Volume:  30     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-09-06     Completed Date:  1989-09-06     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  768-73     Citation Subset:  AIM; IM    
Department of Surgery, Queen's Medical Centre, Nottingham.
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MeSH Terms
Administration, Sublingual
Dilatation / methods
Esophageal Achalasia / drug therapy,  physiopathology,  therapy*
Esophagus / physiopathology*,  radionuclide imaging
Middle Aged
Nifedipine / administration & dosage,  therapeutic use
Reg. No./Substance:

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