[Esophagus and anorectal motility in patients with dysfunction of Oddi's sphincter].
Esophageal and anorectal motility have not been systematically evaluated in patients with sphincter of Oddi dysfunction (SOD). We have investigated 8 consecutive patients (6 females, 52.5 +/- 9.5 y) with type I-SOD (according to the Milwaukee-classification), 12 patients (9 females, 50.4 +/- 12.3 y) with type III-SOD, and 20 healthy volunteers (15 females, 48.5 +/- 15.2 y) by means of a standardized questionnaire for esophageal and anorectal symptoms, esophageal manometry, colonic transit time evaluation, and anorectal manometry. Symptom-scores did not differ significantly between type-I and type III-SOD-patients, respectively. Furthermore, there were no relevant differences of the symptom-scores of the SOD-patients vs. healthy subjects. However, the lower esophageal sphincter pressure (LESP) was significantly higher in patients with type I-SOD (26.8 +/- 7.4 mmHg) than in both, type III-SOD-patients (20.3 +/- 4.0 mmHg, p < 0.05) and healthy subjects (18.6 +/- 3.5 mmHg, p < 0.001), respectively. Mean colonic transit time did not differ significantly between both groups of patients (type I-SOD, 27.9 +/- 21.4 h, vs. type III-SOD, 28.5 +/- 15.1 h, p < 0.05). The anal sphincter resting pressure (ARP) was significantly higher in patients with type I-SOD (90.8 +/- 15.5 mmHg) than in healthy subjects (74.1 +/- 10.3, p < 0.01), but did not differ significantly from that in patients with type III-SOD (82.1 +/- 11.5 mmHg, p = 0.17). Computer-assisted "beat-to-beat"-evaluation showed an abnormal heart rate variability in 3/8 patients with type I-SOD. These results give evidence for a systemic involvement of the lower esophageal and the anal sphincter in patients with type I-SOD, which does not occur in patients with type III-SOD.
Wehrmann
T
T
Medizinische Klinik II, J. W. Goethe-Universität, Frankfurt am Main.
Wiemer
K
K
Lembcke
B
B
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003106:Colon / Q000503:physiopathology; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000503:physiopathology*; D004943:Esophagogastric Junction / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D005772:Gastrointestinal Transit / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012007:Rectum / Q000503:physiopathology; D009803:Sphincter of Oddi / Q000503:physiopathology*
Osophagus- und anorektale Motilität bei Patienten mit Sphinkter-Oddi-Dysfunktion.