PMID- 8942540
OWN - NLM
STAT- MEDLINE
DCOM- 19961230
LR  - 20041117
IS  - 0002-9610 (Print)
IS  - 0002-9610 (Linking)
VI  - 172
IP  - 5
DP  - 1996 Nov
TI  - The hypertensive lower esophageal sphincter.
PG  - 439-42; discussion 442-3
AB  - BACKGROUND: This study defines the entity of the hypertensive lower esophageal 
      sphincter (HLES) and its treatment, including surgical implications. METHODS: 
      Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES 
      with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting 
      LES pressure. Thirty-two of these patients had 24-hour esophageal pH studies. The 
      response to treatment was assessed. RESULTS: Fourteen patients (26%) with HLES 
      had achalasia. Of the remaining 39 (74%), 25 had an isolated HLES with normal 
      esophageal body motility, 5 had a nonspecific esophageal motility disorders 
      (NEMD), 4 were post-Nissen fundoplication, 3 had a nutcracker esophagus, and 2 
      had diffuse esophageal spasm (DES). Nineteen percent of HLES patients had 
      gastroesophageal reflux on pH studies. Eighty-two percent of HLES patients 
      responded well to symptom-directed medical therapy. Two patients with esophageal 
      body dysmotility responded well to an esophageal myotomy with a partial 
      fundoplication. CONCLUSIONS: Patients with the HLES form a heterogeneous group. 
      Gastroesophageal reflux in HLES patients is not uncommon. Patients with HLES 
      respond well to medical therapy. Carefully selected patients require surgery.
FAU - Katada, N
AU  - Katada N
AD  - Department of Surgery, Creighton University, Omaha, Nebraska, USA.
FAU - Hinder, R A
AU  - Hinder RA
FAU - Hinder, P R
AU  - Hinder PR
FAU - Lund, R J
AU  - Lund RJ
FAU - Perdikis, G
AU  - Perdikis G
FAU - Stalzer, R A
AU  - Stalzer RA
FAU - McGinn, T R
AU  - McGinn TR
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
SB  - IM
CIN - Am J Surg. 1997 May;173(5):454-5. PMID: 9168090
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Esophageal Motility Disorders/*etiology/physiopathology/surgery
MH  - Esophagogastric Junction/*physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension/*complications/physiopathology
MH  - Male
MH  - Manometry
MH  - Middle Aged
EDAT- 1996/11/01 00:00
MHDA- 1996/11/01 00:01
CRDT- 1996/11/01 00:00
PHST- 1996/11/01 00:00 [pubmed]
PHST- 1996/11/01 00:01 [medline]
PHST- 1996/11/01 00:00 [entrez]
AID - S0002-9610(96)00219-X [pii]
AID - 10.1016/S0002-9610(96)00219-X [doi]
PST - ppublish
SO  - Am J Surg. 1996 Nov;172(5):439-42; discussion 442-3. doi: 
      10.1016/S0002-9610(96)00219-X.