21. Achalasia was defined as failure of relaxation of a hypertensive or normal lower oesophageal sphincter with absent peristalsis in the oesophageal body. 22. In two cases intubation failed and in four there was failure to cross the lower oesophageal sphincter. 23. The pressure in and length of the lower oesophageal sphincter were assessed with rapid pull through technique. 24. Among these factors, a reduced basal tone and frequent episodes of inappropriate relaxation of the lower oesophageal sphincter are regarded as the most important. 25. The newest prokinetic agent, cisapride, a cholinomimetic drug, has been shown to improve function of the lower oesophageal sphincter and to improve oesophageal and gastric clearance. 26. Throughout the insertion procedure, pressure and pH were displayed continuously on a computer monitor for identification of the lower oesophageal sphincter. 27. The lower oesophageal sphincter acts as a value allowing passage of swallowed liquid and food into the stomach, while preventing regurgitation of gastric contents into the oesophagus. 28. This displacement is limited to the mucosa, however, and does not involve the muscular layer, because the lower oesophageal sphincter undergoes no dislocation. 29. The manometric features of the lower oesophageal sphincter are shown in Table II. 30. Control subjects showed significantly higher resting lower oesophageal sphincter pressure compared with all degrees of oesophagitis. |