Autonomic nerve dysfunction in patients with bolus-specific esophageal dysmotility.
The pathogenetic mechanisms causing esophageal dysmotility is not well understood. We examined 13 patients with solid bolus dysphagia in a radiologic barium study including the swallowing of a 14-mm tablet. In all 13 patients the tablet was caught in the proximal or midesophagus. In 8 patients, the entrapment was associated with symptoms (Group 1) whereas in 5 patients (Group 2), no symptoms were reported. All 13 patients together with a control group of 56 healthy, nondysphagic subjects were tested for autonomic nerve function. Autonomic nerve function tests included registration of electrocardiographic R-R interval variation during deep breathing test (E/I ratio), a test of parasympathetic, vagal, nerve function. The results showed that the E/I ratio was significantly lower in patients with symptoms of bolus-specific esophageal dysmotility (-2,19 [1.76]) (median [interquartile range]) compared with patients without symptoms (0.05 [2, 87], p = 0.0192) and controls (-0.25 [1.26], p = 0.0009). In conclusion, symptomatic bolus-specific esophageal dysmotility is associated with vagal nerve dysfunction.
Department of Radiology, University of Lund, Malmö General Hospital, Sweden.
O
O
Ekberg
R
R
Olsson
H
H
Nilsson
B
B
Lilja
G
G
Sundkvist
D000293:Adolescent; D000328:Adult; D017776:Autonomic Pathways / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000503:physiopathology*; D005260:Female; D005547:Foreign Bodies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014630:Vagus Nerve / Q000503:physiopathology*