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Oesophageal Dysmotility

Botox in Achalasia

The most common method for delivering BT involves visual estimation of the location of LES and injection of 1 mL aliquots (20 to 25 units BT/mL) into each of four quadrants approximately 1 cm above the Z-line. The Z-line is the squamocolumnar junction, which corresponds to the gastroesophageal junction in the absence of Barrett’s esophagus. Initial response rates 70-90% One…

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High Resolution Manometry

We have been delighted with the results of our new high resolution manometry service. We have now investigated over 40 patients in the last few months. It has enabled us to diagnose a host of conditions that conventional manometry does not have the ability to define. As one of the first district general hospitals to embrace this cutting edge technology…

Achalasia: New HRM Classification

Gastroenterology 2008;135:1528-1533 Type 1 – Classic achalasia with minimal oesophageal pressurization Type 2 – Achalasia with oesophageal compression Type 3 – Achalasia with spasm, functional obstruction, some peristalsis Response to therapy Type 1 – 56% overall Type 2 – 71% BoTox, 91% Balloon Dilatation, 100% Heller’s Myotomy Type 3 – 29% overall