Long‐Term pH and Manometric Evaluation of the Distal Esophagus After Endoscopic Sclerotherapy of Esophageal Varices

Abstract

Endoscopic sclerotherapy (ES) of esophageal varices is widely used as an effective treatment for recurrent esophageal bleeding. Retrosternal pain, dysphagia, and esophageal strictures are frequently reported after ES. Alterations in esophageal motility have also been described. In this study, the motility pattern of the esophagus and lower esophageal sphincter (LES) competence were evaluated in a group of 11 patients with portal hypertension and esophageal varices treated by means of ES. Esophageal manometry and pH monitoring of the distal esophagus were carried out before starting ES of esophageal varices, and 2 months and 6 months later. The results of the study demonstrated that ES does not affect LES competence or reduce the amplitude of esophageal motor contractions, but does induce esophageal motility changes consisting of a reduction of esophageal coordination, an increase in the percentage of contraction abnormalities (multipeaked contractions), an increase of the average contraction duration, and an alteration in LES relaxation after swallowing. These motor abnormalities are evident at both early and late control evaluations. However, since only few patients, in the authors' experience, develop esophageal symptoms after ES, these findings represent a minor side effect of the procedure, without clinical implications.