Autonomic dysfunction in non-specific disorders of oesophageal motility

Abstract

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. METHOD: 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.