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Title: High amplitude contractions in the middle third of the esophagus: a manometric marker of chronic alcoholism?
Author: Grande Posa, Luis
Monforte Martínez, Roser
Ros Rahola, Emilio
Toledo-Pimentel, Victor
Estruch Riba, Ramon
Lacima Vidal, Gloria
Urbano Márquez, A. (Álvaro)
Pera Blanco-Morales, Cristóbal
Keywords: Alcohol
Efectes fisiològics
Physiological effect
Issue Date: 1996
Publisher: BMJ Group
Abstract: BACKGROUND--Oesophageal motor abnormalities have been reported in alcoholism. AIM--To investigate the effects of chronic alcoholism and its withdrawal on oesophageal disease. PATIENTS--23 chronic alcoholic patients (20 men and three women; mean age 43, range 23 to 54). METHODS--Endoscopy, manometry, and 24 hour pH monitoring 7-10 days and six months after ethanol withdrawal. Tests for autonomic and peripheral neuropathy were also performed. Motility and pH tracings were compared with those of age and sex matched control groups: healthy volunteers, nutcracker oesophagus, and gastro-oesophageal reflux disease. RESULTS--14 (61%) alcoholic patients had reflux symptoms, and endoscopy with biopsy showed oesophageal inflammation in 10 patients. One patient had an asymptomatic squamous cell carcinoma. Oesophageal motility studies in the alcoholic patients showed that peristaltic amplitude in the middle third was > 150 mm Hg (95th percentile (P95) of healthy controls) in 13 (57%), the ratio lower/ middle amplitude was < 0.9 in 15 (65%) (> 0.9 in all control groups), and the lower oesophageal sphincter was hypertensive (> 23.4 mm Hg, P95 of healthy controls) in 13 (57%). All three abnormalities were present in five (22%). Abnormal reflux (per cent reflux time > 2.9, P95 of healthy controls) was shown in 12 (52%) alcoholic patients, and was unrelated to peristaltic dysfunction. Subclinical neuropathy in 10 patients did not effect oesophageal abnormalities. Oesophageal motility abnormalities persisted at six months in six patients with ongoing alcoholism, whereas they reverted towards normal in 13 who remained abstinent; reflux, however, was unaffected. CONCLUSIONS--Oesophageal peristaltic dysfunction and reflux are frequent in alcoholism. High amplitude contractions in the middle third of the oesophagus seem to be a marker of excessive alcohol consumption, and tend to improve with abstinence.
Note: Reproducció digital del document publicat a:
It is part of: Gut, 1996, vol. 38, num. 5, p. 655-662
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ISSN: 0017-5749
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)

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