Portal de Periódicos da CAPES

434 ESOPHAGITIS AND LOWER ESOPHAGEAL SPHINCTER PRESSURE IN CHILDREN

1978; Springer Nature; Volume: 12; Linguagem: Inglês

10.1203/00006450-197804001-00439

1530-0447

John J. Herbst, Linda Book, Dale B. Johnson,

Eosinophilic Esophagitis

Patients with gastroesophageal reflux (GER) frequently have a decreased lower esophageal sphincter (LES) pressure that increases after surgery, although variable results have been noted in children. LES pressures were measured in 80 patients > 3 months of age with symptomatic GER and in 20 control patients. The esophageal probe was a triple lumen catheter perfused at a rate of 1.5 ml per min. Patients were classified as having severe esophagitis if they had stricture, hematemesis or friable esophageal mucosa at esophagoscopy. Normal patients had mean ± SEM pressures of 11.4 ± 0.9 mm Hg while 20 patients with severe esophagitis had LES pressures of 4.3 ± 0.8 mm Hg (p <.001). Symptomatic GER patients without esophagitis (N=60) had LES pressures of 11.6 ± 0.9 mm Hg. In the 10 esophagitis patients with pre and postoperative LES measurements, the average change was +2 mm Hg, and the mean postoperative LES pressure was not different from controls. Patients without esophagitis who ultimately required surgery had LES pressures that were not different from controls, and the average change in LES pressure in the 20 patients with pre and postoperative studies was -0.5 mm Hg. A low LES pressure with a postoperative increase in pressure was noted only when severe esophagitis accompanied the symptomatic GER. The low LES pressures frequently noted in GER patients may be a result of esophageal inflammation rather than the cause of GER.