Autonomic dysfunction in non-specific disorders of oesophageal motility.
OBJECTIVE
Non-specific disorders of oesophageal motility are common manometric findings in patients presenting with non-cardiac chest pain, dysphagia, odynophagia, regurgitation and symptoms of gastro-oesophageal reflux disease. Impairment of vagal function has been reported in gastro-oesophageal reflux disease and achalasia. The role of autonomic dysfunction in patients with non-specific oesophageal disorders is unknown. The aim of this study was to assess autonomic function in patients with non-specific disorders of oesophageal motility.


METHODS
An automated computerized system (AUTOCAFT) was used to evaluate autonomic function in 62 patients presenting with non-cardiac chest pain and associated oesophageal symptoms. Cardiovascular reflex responses to deep breathing, Valsalva manoeuvre, posture and sustained handgrip were measured and results compared with 14 sex- and age-matched control subjects.


RESULTS
Forty percent of patients with non-specific disorders of oesophageal motility proved to have significant abnormalities of vagal function. There was also a high incidence of gastro-oesophageal reflux (50%).


CONCLUSIONS
There appears to be autonomic dysfunction in patients with non-specific oesophageal motility disorders. Autonomic function tests may prove to be a useful tool in the assessment of oesophageal function.
Pirtniecks
A
A
Oesophageal Laboratory, Northern General Hospital, Sheffield S57AU, Yorkshire, UK.
Smith
L F
LF
Thorpe
J A
JA
D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016022:Case-Control Studies; D002637:Chest Pain / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D014630:Vagus Nerve / Q000503:physiopathology