Relationship between esophageal motility and transit in patients with type I diabetes mellitus.
OBJECTIVE
Delayed esophageal transit and abnormal esophageal motility occur frequently in patients with long-standing diabetes mellitus. However, the relationship between transit and motility has not been assessed directly. The aim of this study was to investigate the patterns of esophageal motor function documented previously to have delayed esophageal emptying and esophageal transit in patients with insulin-dependent diabetes mellitus.


METHODS
Concurrent esophageal manometry and radionuclide measurement of transit of liquids and solids were performed in 11 patients with insulin-dependent diabetes, 10 age-matched controls, and 11 young normal subjects.


RESULTS
Patients with diabetes had a greater frequency of transit hold-up for solids (96%) than did older controls (65%) or young normals (42%) (p < 0.001), whereas the frequency of transit hold-up for liquid boluses was similar among the three groups (diabetics, 36%; older normals, 17%; young normals, 17%). The major mechanism responsible for bolus hold-up in diabetics was peristaltic failure (liquid, 52%; solid, 67%) and the level of hold-up coincided with the level of bolus hold-up for 10/11 liquid and 27/28 solid boluses.


CONCLUSIONS
In insulin-dependent diabetes, retarded esophageal transit usually reflects either peristaltic failure or focal low-amplitude pressure waves.
Holloway
R H
RH
Department of Gastrointestinal Medicine, Royal Adelaide Hospital, South Australia.
Tippett
M D
MD
Horowitz
M
M
Maddox
A F
AF
Moten
J
J
Russo
A
A
D000367:Age Factors; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000209:etiology; D004943:Esophagogastric Junction / Q000503:physiopathology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005502:Food; D005769:Gastrointestinal Motility / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D011312:Pressure; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013667:Technetium; D014867:Water / Q000008:administration & dosage
D019275:Radiopharmaceuticals; D014867:Water; D013667:Technetium