Esophageal transit of liquid in chronic alcoholism in patients with cirrhosis. Influence of esophageal varices.

Disturbances of esophageal motility are often encountered in chronic alcoholism, and numerous physiopathologic mechanisms responsible for this alteration have been documented. The exact role of esophageal varices, however, in inducing esophageal transit abnormalities remains unclear. In this study using scintigraphy, the authors studied esophageal transit in a large number of patients with cirrhosis to assess the direct effect of esophageal varices. Esophageal transit was found altered in 58 out of 141 patients with cirrhosis (41.1%). It was prolonged in 47.3% of patients with esophageal varices and in 29.2% of patients without varices (P < 0.05). The frequency of esophageal transit alteration was also related to the Child-Turcotte-Pugh (CTP) score, an index of the severity of liver disease (P < 0.01). The relationship between CTP class and transit alteration remained statistically significant in the group of patients with esophageal varices (P < 0.05). Conversely, when patients in each CTP class were analyzed separately, the frequency of esophageal transit abnormalities was not different in patients with and without esophageal varices. These results suggest that the severity of cirrhosis, rather than the presence of esophageal varices, constitutes the major factor in inducing esophageal transit alteration in patients with cirrhosis.