Autonomic nerve dysfunction is closely associated with the abnormalities of esophageal motility in reflux esophagitis.
BACKGROUND
While reflux esophagitis (RE) is often associated with esophageal motility dysfunction, the causes of this abnormal motility are not well understood. The aim of our study was to assess the relationship between esophageal motility and autonomic nerve dysfunction by comparing 14 healthy control subjects (11 M, 3 F; mean age, 56.4 years) with 26 patients with RE (19 M, 7 F; mean age, 60.4 years).


METHODS
According to results of esophageal manometry, subjects with RE were assigned to group I (RE with esophageal motility dysfunction, n = 12) or group N (RE without motility dysfunction, n = 14). Autonomic neuropathy was assessed by measuring the heart rate coefficient of variation at rest (CVR-R), the Valsalva ratio for the R-R interval, the systolic blood pressure response to mental calculation, and the antral contractile response to modified sham feeding (MSF).


RESULTS
CVR-R at rest was lower in group I (2.08 +/- 0.18) than in group N (3.80 +/- 0.44; P < 0.05). The frequency of antral contractile response to MSF per 3-min interval over 15 min was significantly lower in group I than in either group N or controls. The 15-min integrated antral contractile response, taken as the area under the contraction time curve, was much lower in group I (13.2 +/- 6.2) than in controls (55.6 +/- 9.2; P < 0.01).


CONCLUSIONS
We conclude that esophageal motor dysfunction in some patients with RE may result from autonomic dysfunction.
Manabe
N
N
Dept. of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Japan. n_manabe@hkg.odn.ne.jp
Haruma
K
K
Hata
J
J
Nakamura
K
K
Tanaka
S
S
Chayama
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000175:diagnosis; D015154:Esophageal Motility Disorders / Q000150:complications*; D004942:Esophagitis, Peptic / Q000150:complications / Q000503:physiopathology*; D004947:Esophagus / Q000294:innervation / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction; D009460:Neurologic Examination; D011706:Pyloric Antrum / Q000503:physiopathology