Esophageal motility in patients with esophageal caustic injury.

Abstract

There are few studies of esophageal function subsequent to the ingestion of lye. We investigated the esophageal motility of patients who had ingested liquid sodium hydroxide. Esophageal manometry was performed on 21 patients who [1-53 yr before the manometric examination (median: 13 yr)] had drunk 10-30 g of sodium hydroxide diluted in water. The results were compared with those obtained for a control group of 22 healthy volunteers. The lower esophageal sphincter (LES) pressure of the caustic group (14.9 +/- 1.7 mm Hg, mean +/- SE) did not differ (p > 0.05) from that of the control group (17.4 +/- 1.1 mm Hg). LES pressure in eight patients was below 10 mm Hg. The amplitude of contraction was lower (p < 0.01) in the caustic group than in the control group. In the proximal part of the esophageal body, the duration of contraction was longer (p < 0.01) in the caustic group (2.3 +/- 0.1 s) than in controls (1.8 +/- 0.1 s). Nonperistaltic contraction was a finding in 14 patients, repetitive in five of them. The velocity of peristaltic contractions was higher (p < 0.05) in the caustic group (distal: 3.2 +/- 0.2 cm/s) than in the control group (2.2 +/- 0.2 cm/s). Although there was some impairment of esophageal motor function in 71% of the patients, they were asymptomatic when we performed esophageal manometry. Esophageal motility impairment was present in most of the patients who ingested sodium hydroxide. Nonperistaltic contractions of low amplitude were found most frequently.