Oesophageal motility after sclerotherapy for bleeding varices

Endoscopic injection sclerotherapy (ST) has gained wide acceptance as emergency and definitive treatment of bleeding oesophageal varices. The long-term effects of serial ST on oesophageal motility were studied in 19 patients with cirrhosis and prior variceal bleeding. A control group of 14 patients with compensated cirrhosis has been conservatively treated for major variceal haemorrhage a median of 5 months previously. In the ST group, eradication of the varices by serial ST had been completed a median of 7 months prior to manometry. The manometric results did not differ between the controls and 11 ST patients without dysphagia (SA). In eight ST patients with dysphagia (SB), the percentage of deglutitive peristaltic contractions (DPC) in the lower oesophagus was less than in the controls (31.4 vs. 98.6%) and in the SA patients (84%). Nonpropulsive contractions instead dominated in the lower oesophagus, but were frequent also in the upper part, resembling the motility pattern seen in patients with sclerodermal involvement of the oesophagus. When seven SB patients were reinvestigated after a median of 11.5 months (without further ST), the DPC value had increased to 74.2% and the dysphagia had decreased. The lower oesophageal sphincter pressure did not differ between the controls and the subgroups of ST patients.