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Vagal dysfunction following endoscopic variceal sclerotherapy
F P Mistry1, D Sreenivasa, N M Narawane
1Department of Gastroenterology, K E M Hospital, Mumbai.
Summary
Sclerotherapy may impair vagus nerve function, leading to reduced gastric acid secretion in patients with portal hypertension. This dysfunction might stem from periesophageal inflammation following multiple treatment sessions.
Area of Science:
- Gastroenterology
- Vascular Medicine
- Surgical Complications
Background:
- Sclerotherapy, a treatment for esophageal varices, can affect adjacent structures.
- The impact of sclerotherapy on the vagus nerve, crucial for gastric function, remains unclear.
Purpose of the Study:
- To investigate vagal nerve function by measuring gastric acid secretion after sclerotherapy in portal hypertensive patients.
- To establish a correlation between sclerotherapy and potential vagal dysfunction.
Main Methods:
- Assessed gastric acid secretion using the modified sham feeding test.
- Mapped gastric acid-secreting mucosa with the Congo red test.
- Compared patients with portal hypertension who underwent sclerotherapy to a control group without sclerotherapy.
Main Results:
- Eight patients showed reduced acid-secreting mucosa post-sclerotherapy compared to controls.
- These patients exhibited significantly lower gastric acid secretion during the modified sham feeding test.
Conclusions:
- Multiple sclerotherapy sessions are associated with decreased gastric acid secretion, suggesting vagal dysfunction.
- Vagus nerve impairment may result from periesophageal inflammation induced by sclerotherapy.