PMC3659367_01
Manometry tracings of the achalasia patient. Rhythmic simultaneous contractions occur at 7/min. Drotaverine inhibits the frequency without changing the amplitude. Drotaverine was given about 1 min before the vertical line was placed on the recording. A subsequent wet swallow (wet) markedly increased the frequency. The numbers at the left are the distance of the manometry port in cm away from the nasal edge. The bottom trace is the LES where both drotaverine and a wet swallow are seen to reduce the LES pressure. The amplitude of the spontaneous rhythmic contractions were between 35 and 45 mm Hg. The maximum LES pressure during this recording period was 30 mm Hg.
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F1
Esophageal manometry using a 8-channel water perfused system with a Dent sleeve for LES pressure, showed high LES pressure and regular spontaneous rhythmic non-propagating contractions in the esophageal body at a frequency of 7/min, with an amplitude between 48 and 51 mm Hg (Figures 1, 2). Drotaverine hydrochloride (40 mg intramuscular) was given to reduce the LES pressure; this markedly reduced the contraction frequency from 7 to 3/min without a significant effect on the amplitude; a subsequent wet swallow increased the frequency to 9/min and also increased the contraction amplitude (Figure 1).
Comparison of dry swallows (dry) and wet swallows (wet). The first dry swallow has no effect on amplitude or frequency of the rhythmic contractions. Subsequent dry swallows tend to decrease the amplitude of the contractions. The first and third wet swallows markedly increase the frequency. The amplitude of the spontaneous contractions were between 20 and 40 mm Hg. The maximum LES pressure during this recording period was 50 mm Hg.
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F2
Esophageal manometry using a 8-channel water perfused system with a Dent sleeve for LES pressure, showed high LES pressure and regular spontaneous rhythmic non-propagating contractions in the esophageal body at a frequency of 7/min, with an amplitude between 48 and 51 mm Hg (Figures 1, 2). An initial dry swallow did not affect the contractile activity but two subsequent dry swallows decreased amplitude and frequency (Figure 2). Subsequent wet swallows, using 20 ml of warm water, increased the frequency to 8/min and also increased the amplitude (Figure 2).