The prevalence of failed primary esophageal peristalsis (FPP) in MIEI
with and without risk factors
Bancha Ovartlarnporn, Assoc. Prof., D. of Internal Medicine, F. of Medicine, PSU.
Teerha Piratvisuth, Assoc. Prof., D. of Internal Medicine, F. of Medicine, PSU.
Noppawan Osatakul, Nurse, D. of Surgery, F. of Medicine, PSU.
Corresponding e-mail : ptimmy@ratree.psu.ac.th
Published : J Gastroenterol Hepatol, 1999 14(Suppl.) : S76
Key words : MIEI, esophageal motility disorder
Risk factors in MIEI include immediate lying down after drug ingestion, water chaser < 100 ml, drug physical characters and obvious esophageal disorders. The role of subclinical motility disorder has never been evaluated before.
Aim : To compare the prevalence of subclinical esophageal motility disorder in MIEI patients without obvious esophageal diseases categorized by the presence (group A) or absence (group B) of the risk factors.
Methods : 19 cases were prospectively studied from Feb. 1994 to Feb. 1999. Detail history of immediate lying down and water chaser amount were recorded. Esophageal manometry (EM) was
done prior to endoscopy and those with abnormal EM had the 2nd EM scheduled 2 weeks later. The number of ulcer was recorded and biopsies from ulcers were done to exclude other causes of ulcera-tion.
Results : There were 16 females and 3 males with the mean age ± SD of 34.6±10.01 and a
range of 20-57 years. EM showed LES pressure of 6.33-48.33 mmHg, mean persistaltic amplitude
of 40.08-133.97 mmHg and complete relaxation of LES. FPP after wet swallow was found in 4 of
12 in group A and in 6 of 7 in group B but the difference was not significant (FisherŐs exact test p=
0.057). The extent of ulceration in these two groups was comparable. The second EM in 5 of 7 with
FPP showed persistent FPP in 3
Conclusions : FPP may be the predisposing factor for MIEI in some cases and may increase
the risk of further injury if the drugs were continued. Ulceration of esophagus may not be responsible for the FPP.
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