A Study of Esophageal Motility changes following Endoscopic Variceal Band Ligation or sclerotherapy using High Resolution Manometry

Malarvizhi, M (2012) A Study of Esophageal Motility changes following Endoscopic Variceal Band Ligation or sclerotherapy using High Resolution Manometry. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Portal Hypertension causes Gastrointestinal Bleeding. It is most frequently due to Gastro Esophageal varices (65-70%) and isolated Gastric varices (10-15%). Endoscopic therapy is the only treatment modality that is widely accepted for the prevention of variceal bleeding, control of acute variceal bleeding, and prevention of variceal rebleeding. Endoscopic Variceal therapy includes Variceal Sclerotherapy and Variceal Band Ligation. The technique involves injection of a sclerosant into (intravariceal) or adjacent to (paravariceal) a varix. Some paravariceal injection usually takes place during attempted intravariceal therapy. The sclerosants used include sodium tetradecyl sulfate, sodium morrhuate, ethanolamine oleate, and absolute alcohol. AIM OF THE STUDY: To study the Esophageal Motility changes following Endoscopic Variceal Band Ligation or Sclerotherapy using High resolution Manometry. MATERIAL AND METHODS: Study Design : Prospective study. Total no. of subjects : 20. Patients who were diagnosed to have portal hypertension who were referred to the department of Gastroenterology at Madras Medical College Hospital were included in this study. The diagnosis of portal hypertension and its etiology was established by Clinical Biochemical Imaging and Histology if needed An informed consent was obtained from these patients, A baseline Esophageal Manometry is done for these patients using High Resolution Manometry Depending on the clinical situations these patients were subjected to Endoscopic Variceal Sclerotherapy and or Variceal Band Ligation. CONCLUSION: Endosocpic Sclerotherapy and Endoscopic Variceal Band Ligation causes Dysmotility. Dysmotility can occur a late complication due to persistent chronic inflammatory changes. High Resolution Manometry is a Novel method to identify focal segmental changes in motility following Endoscopic Sclerotherapy and Endoscopic Variceal Band Ligation. In this study there was manometric changes in the form of decreased amplitude and velocity of contraction in the Lower Esophagus. The motility changes were more commonly found in the Endoscopic sclerotherapy group. Though in our study the two groups were not comparable in Number. The number of sessions did not correlate with the Endoscopic Sclerotherapy group but in a group of patient who underwent both therapy they developed motility changes after third session. In this study there were no abnormal waves and Non peristaltic waves, no prolongation of duration of peristaltic waves. None of these patients had any symptoms. Endoscopic variceal sclerotherapy causes Esophageal motility changes six months after therapy. There was no motility changes following Endoscopic Variceal Band Ligation alone was used. These changes do not causes any dysmotility symptoms in patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Esophageal Motility, Endoscopic Variceal Band Ligation, sclerotherapy, High Resolution Manometry.
Subjects: MEDICAL > Gastroenterology
Depositing User: Subramani R
Date Deposited: 07 Mar 2020 09:29
Last Modified: 07 Mar 2020 09:31
URI: http://repository-tnmgrmu.ac.in/id/eprint/12168

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