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. 1996 Feb;38(2):166–170. doi: 10.1136/gut.38.2.166

Effects of mediastinal irradiation on oesophageal function.

E Yeoh 1, R H Holloway 1, A Russo 1, M Tippett 1, H Bermingham 1, B Chatterton 1, M Horowitz 1
PMCID: PMC1383017  PMID: 8801191

Abstract

Although it is well recognised that oesophageal symptoms are common during therapeutic mediastinal irradiation of intrathoracic malignant diseases, the effects of mediastinal irradiation on oesophageal function are poorly defined. To clarify the pathogenesis of these sequelae a prospective study was performed to document comprehensively the effects of mediastinal irradiation on oesophageal function. Oesophageal symptoms, barium swallow, endoscopy, and combined radionuclide scintigraphy and oesophageal manometry were evaluated in eight patients with potentially curable intrathoracic malignant disease before treatment, during the last week of mediastinal irradiation, and six to eight weeks after its completion. Before irradiation, structural abnormalities were excluded by barium swallow and endoscopy. All but one patient experienced odynophagia or dysphagia, or both, during mediastinal irradiation (p < 0.001) but endoscopic abnormalities were observed in only three patients and there was no correlation between oesophageal symptoms and endoscopic changes. Irradiation, however, had no significant effect on oesophageal motility or transit. It is concluded that oesophageal symptoms which develop during mediastinal irradiation are not a result of altered oesophageal motility or transit and may reflect increased mucosal sensitivity.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Accarino A. M., Azpiroz F., Malagelada J. R. Symptomatic responses to stimulation of sensory pathways in the jejunum. Am J Physiol. 1992 Nov;263(5 Pt 1):G673–G677. doi: 10.1152/ajpgi.1992.263.5.G673. [DOI] [PubMed] [Google Scholar]
  2. Arndorfer R. C., Stef J. J., Dodds W. J., Linehan J. H., Hogan W. J. Improved infusion system for intraluminal esophageal manometry. Gastroenterology. 1977 Jul;73(1):23–27. [PubMed] [Google Scholar]
  3. Blackwell J. N., Hannan W. J., Adam R. D., Heading R. C. Radionuclide transit studies in the detection of oesophageal dysmotility. Gut. 1983 May;24(5):421–426. doi: 10.1136/gut.24.5.421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dent J. A new technique for continuous sphincter pressure measurement. Gastroenterology. 1976 Aug;71(2):263–267. [PubMed] [Google Scholar]
  5. Holloway R. H., Lange R. C., Plankey M. W., McCallum R. W. Detection of esophageal motor disorders by radionuclide transit studies. A reappraisal. Dig Dis Sci. 1989 Jun;34(6):905–912. doi: 10.1007/BF01540277. [DOI] [PubMed] [Google Scholar]
  6. LaManna M. M., Parker J. A., Wolodzko J. G., Zekavat P. P., Popky G. L. Radionuclide esophageal and intestinal transit scintigraphy in patients undergoing radiation therapy. Radiat Med. 1985 Jan-Mar;3(1):13–16. [PubMed] [Google Scholar]
  7. Mearin F., Cucala M., Azpiroz F., Malagelada J. R. The origin of symptoms on the brain-gut axis in functional dyspepsia. Gastroenterology. 1991 Oct;101(4):999–1006. doi: 10.1016/0016-5085(91)90726-2. [DOI] [PubMed] [Google Scholar]
  8. Nicolopoulos N., Mantidis A., Stathopoulos E., Papaodysseas S., Kouvaris J., Varveris H., Papavasiliou C. Prophylactic administration of indomethacin for irradiation esophagitis. Radiother Oncol. 1985 Jan;3(1):23–25. doi: 10.1016/s0167-8140(85)80005-0. [DOI] [PubMed] [Google Scholar]
  9. Schoeman M. N., Holloway R. H. Stimulation and characteristics of secondary oesophageal peristalsis in normal subjects. Gut. 1994 Feb;35(2):152–158. doi: 10.1136/gut.35.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Soffer E. E., Mitros F., Doornbos J. F., Friedland J., Launspach J., Summers R. W. Morphology and pathology of radiation-induced esophagitis. Double-blind study of naproxen vs placebo for prevention of radiation injury. Dig Dis Sci. 1994 Mar;39(3):655–660. doi: 10.1007/BF02088356. [DOI] [PubMed] [Google Scholar]
  11. Vanek A. W., Diamant N. E. Responses of the human esophagus to paired swallows. Gastroenterology. 1987 Mar;92(3):643–650. doi: 10.1016/0016-5085(87)90012-6. [DOI] [PubMed] [Google Scholar]
  12. de Caestecker J. S., Blackwell J. N., Adam R. D., Hannan W. J., Brown J., Heading R. C. Clinical value of radionuclide oesophageal transit measurement. Gut. 1986 Jun;27(6):659–666. doi: 10.1136/gut.27.6.659. [DOI] [PMC free article] [PubMed] [Google Scholar]

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