Lower oesophageal sphincter pressure and timed barium oesophagogram: Two objective parameters in the non-invasive assessment of primary achalasia

Abstract

Background: The non-invasive assessment of primary achalasia is not precise. Aim: To compare investigations before and 1 month after balloon dilation in achalasia. Methods: Fifty-two patients with primary achalasia were enrolled. Subjective and objective variables of oesophageal functions were analysed before and 1 month after balloon dilation. Results: The mean predilation symptom score, lower oesophageal sphincter pressure, height and volume of barium at 5 min were 7.7 ± 2.6, 62.0 ± 25.1 mmHg, 9.2 ± 6.1 cm and 53.2 ± 49.8 mL respectively; the mean postdilation values were 3.0 ± 3.0, 34.1 ± 12.5 mmHg, 7.9 ± 5.1 cm and 28.0 ± 30.1 mL respectively. The before dilation volume of barium at 5 min correlates significantly with lower oesophageal sphincter pressure (P < 0.01). The mean symptom scores, lower oesophageal sphincter pressure and volume of barium at 5 min dropped significantly after intervention (P < 0.01), but the reduction in barium height at 5 min was not significant. The percentage changes in volume at 5 min significantly predicted the percentage changes in lower oesophageal sphincter pressure (P < 0.01). Conclusions: The volume of barium retention at 5 min can predict the lower oesophageal sphincter pressure before and after balloon dilation in primary achalasia. This could be used as a non-invasive objective tool for initial and post-dilation assessment. © 2005 Blackwell Publishing Ltd.