Pharmacological manipulation of the lower esophageal sphincter and its impact on the variceal pressure in patients with schistosomal portal hypertension

ABSTRACT

Eighty patients and 20 volunteers included in the present study. They were divided into three groups Group A [60 patients with schistosomal portal hypertension and esophageal varices, i.e. the study group], group B [20 patients with schistosomal portal hypertension without esophageal varices], and group C [20 normal volunteers] comprised the control group. In all subjects, the lower esophageal sphincter pressure [LOSP] was measured. Variceal pressure [VP] was measured in patients of group A using the Mossiman's pneumatic pressure gauge. Pressure measurements were repeated after administration of metoclopramide, hyoscine butyl bromide, pentagastrin and vasopressin. The results of the study showed that the mean LOSP in normal controls was 21.22 +/- 6.3 cm H2O which was significantly higher than that in group B [14 +/- 7.73 cm H2O] and group A [11.68 +/- 5.37 cm H2O]. However, there was no statistical correlation between LOSP and VP. The response of VP to the administered drugs was minimal and insignificant. Moreover, LOSP changes in groups A and B in response to these drugs were negligible compared with that in group C