Ann Thorac Surg 1988;45:303-305
© 1988 The Society of Thoracic Surgeons
Reflux Patterns in Patients with Achalasia without Operation
J. Patrick Shoenut, B.Sc.,
Brian G. Trenholm, M. Eng.,
Allan B. Micflikier, M.D., F.R.C.P.(C),
John M. Teskey, M.D., F.R.C.S.(C)*
From the Departments of Medicine, Surgery, Radiology, and Biomedical Engineering, St. Boniface General Hospital and the University of Manitoba, Winnipeg, Man, Canada
Accepted for publication October 15, 1987.
* Address reprint requests to Dr. Teskey, 404-400 Tache Ave, Winnipeg, Man, Canada R2H 3C3
Five patients with achalasia who had not had an operation underwent esophageal manometry and 24-hour, ambulatory pH monitoring to determine the pattern and extent of esophageal reflux. One patient had reflux within normal limits. In 2 patients, reflux occurred 0.5% of the total time and no episodes of supine reflux were recorded. In the 2 remaining patients, reflux was measured 16.8% and 55.3% of the total time; however, in both patients, these results were influenced by lengthy bouts of supine reflux. These indices of reflux were not influenced by differences in resting lower esophageal sphincter tone, position, or length. Twenty-four-hour esophageal pH monitoring can be useful in the preoperative assessment of patients with achalasia, and the information obtained might influence the choice of operative procedure.
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