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Does lower esophageal sphincter incompetency contribute to esophageal bleeding?
Gastroenterology
|August 1, 1976
Summary
Lower esophageal sphincter (LES) pressure is similar in liver cirrhosis patients and controls. LES incompetency and acid reflux are unlikely causes of variceal bleeding in cirrhosis.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Background:
- Liver cirrhosis is associated with portal hypertension and an increased risk of variceal bleeding.
- The role of lower esophageal sphincter (LES) function in the pathogenesis of variceal bleeding in cirrhosis is not fully understood.
- Gastroesophageal reflux is a common condition, but its association with cirrhosis and varices requires investigation.
Purpose of the Study:
- To investigate the prevalence of lower esophageal sphincter (LES) incompetency in patients with liver cirrhosis.
- To determine if LES incompetency contributes to the development of variceal bleeding in this population.
- To assess the relationship between LES pressure, gastroesophageal reflux, and hepatic decompensation.
Main Methods:
- Measurement of resting lower esophageal sphincter (LES) pressure in 35 patients with liver cirrhosis and a control group.
- Assessment of LES response to gastric alkalinization.
- Evaluation of symptoms and radiological evidence of gastroesophageal reflux.
- Correlation of LES pressure with clinical parameters such as ascites, variceal hemorrhage, and hepatic decompensation.
Main Results:
- Resting LES pressure in cirrhotic patients (17.8 +/- 1.1 mm Hg) was comparable to controls (17.3 +/- 2.0 mm Hg).
- No significant differences in LES pressure were observed based on the presence of ascites, variceal hemorrhage, or hepatic decompensation severity.
- Both patient and control groups demonstrated a significant increase in LES pressure upon gastric alkalinization.
- Gastroesophageal reflux symptoms and radiological findings were infrequent in patients with liver cirrhosis.
Conclusions:
- Lower esophageal sphincter (LES) incompetency is not a common finding in patients with liver cirrhosis.
- LES pressure and function appear to be preserved in cirrhosis, irrespective of disease severity or complications.
- Acid-pepsin regurgitation is unlikely to be a significant contributing factor to the development of variceal hemorrhage in liver cirrhosis.
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