Oesophageal motility following endoscopic injection sclerotherapy: a scintigraphic study

ABSTRACT

Endoscopic injection sclerotherapy [EIS] is now widely used in the management of bleeding esophageal varices. Different studies have concluded controversial effects of EIS on esophageal motility. Esophageal motility was investigated in 15 patients belonging to 3 groups of patients following EIS. The first group was left with a scarred esophagus, the second group had a smooth esophagus and the third group was subjected to a sclerotherapy session during the week prior to the test. Patients were compared with controls with varices prior to treatment as well as to healthy volunteers. Esophageal motility was assessed using a sensitive scintigraphic technique which determines the total esophageal transit time as well as the transit time in each third of the esophagus. The results showed that the total and middle transit times are prolonged in group 1 and group 3 when compared with healthy controls but not when the comparison is made with patients having esophageal varices. This favors the concept that esophageal varices per se are a major cause of esophageal dysmotility. The proximal transit time was also significantly prolonged in the group of patients with varices examined immediately following sclerotherapy compared with controls indicating a transient dysfunction following each EIS session. The distal transit time was only significantly different from controls in groups 2 and 3 and in patients with esophageal varices prior to EIS. It can be concluded that judiciously performed EIS leaving a smooth esophagus can have little or no effect on motility