PMID- 19858590
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20091211
LR  - 20191111
IS  - 1998-4049 (Electronic)
IS  - 1319-3767 (Linking)
VI  - 12
IP  - 2
DP  - 2006 Apr-Jun
TI  - Hypertensive lower esophageal sphincter (HLES): prevalence,symptoms genesis and 
      effect of pneumatic balloon dilatation.
PG  - 77-82
AB  - SUMMARY AND BACKGROUND DATA: The Hypertensive lower esophageal sphincter (HLES) 
      is an unusual primary motor disorder of the esophagus. The significance of this 
      motility disorder is still questionable. OBJECTIVE: The objectives were: (a) 
      identification of the prevalence of HLES in these patients, (b) identification of 
      the common presenting symptoms of HLES, (c) study of the correlation of the 
      symptoms with LESP and (d) study of the effectiveness of pneumatic balloon 
      dilation in cases that fail to respond to medical treatment. METHODS: A 
      retrospective study that includes four thousand one hundred and seventy patients, 
      who were subjected to esophageal manometry in the period from January 1994 to 
      December 2003, among whom sixty-six patients with HLES (LESP> 40 mmHg) were 
      found. In addition to manometry, upper endoscopy was done to forty-nine patients, 
      upper GI barium studies to thirty-eight patients and esophageal pH- metry to 
      sixteen patients. RESULTS: showed that most of our patients were females (45 
      females and 21 males), with a mean age of 36.6 +/- 14 years. Patients with 
      dysphagia (57.5%) had the highest LESP (52.1 +/- 21, mmHg) while patients with 
      chest pain (47%) had the highest distal esophageal contraction amplitude (153.9 
      +/- 93.2 mmHg). Endoscopy showed varying degrees of esophagitis in 17 patients 
      (34%). Barium studies showed corkscrew esophagus in seven patients (18.4%) and 
      dilated esophagus in nine patients (23.7%). LESP was highest in patients with 
      dilated esophagus (57.5 +/- 33.4 mmHg). All our patients were subjected to 
      medical treatment, of which twelve patients underwent pneumatic dilation with 
      successfully reduced LESP and symptoms relief in 91% of patients. CONCLUSIONS: It 
      was concluded that the prevalence of HLES is around 1.6, in which dysphagia and 
      chest pain are the usual presenting symptom, and that pneumatic balloon 
      dilatation is very effective when properly applied. It will probably occupy the 
      same position it has in achalasia.
FAU - El-Hak, Nabil A Gad
AU  - El-Hak NA
AD  - Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt. 
      gadelhak_n_eg@hotmail.com
FAU - Mostafa, Mohamed
AU  - Mostafa M
FAU - AbdelHamid, Hussein
AU  - AbdelHamid H
FAU - Haleem, Magdy
AU  - Haleem M
LA  - eng
PT  - Journal Article
PL  - India
TA  - Saudi J Gastroenterol
JT  - Saudi journal of gastroenterology : official journal of the Saudi 
      Gastroenterology Association
JID - 9516979
EDAT- 2006/04/01 00:00
MHDA- 2006/04/01 00:01
CRDT- 2009/10/28 06:00
PHST- 2009/10/28 06:00 [entrez]
PHST- 2006/04/01 00:00 [pubmed]
PHST- 2006/04/01 00:01 [medline]
AID - SaudiJGastroenterol_2006_12_2_77_27850 [pii]
AID - 10.4103/1319-3767.27850 [doi]
PST - ppublish
SO  - Saudi J Gastroenterol. 2006 Apr-Jun;12(2):77-82. doi: 10.4103/1319-3767.27850.