The Hypertensive Gastroesophageal Sphincter a Manometric and Clinical Study

The manometric and clinical findings in 45 patients with hypertensive gastroesophageal sphincter have been analyzed. Twenty-nine of the patients were females and 16 males. Average age 52 years. In all cases pain was the predominant symptom, and 26 patients had dysphagia besides. It is pointed out that the diagnosis may be difficult in cases without dysphagia, and it is recommended that a manometric study be carried out in all cases of retrosternal and epigastric pain, especially when conventional diagnostic methods have failed to disclose an organic cause fitting in with the symptoms and signs. Treatment by spasmolytics had at best a short-lived effect, and in 3 cases myotomy in the sphincteric area was performed. The result was good in all cases, but it is concluded that, owing to the risk of reflux, this pocedure should be reserved for patients with frequent and intense pain.