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Autonomic nerve dysfunction in patients with bolus-specific esophageal dysmotility

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Abstract

The pathogenetic mechanisms causing esophageal dysmotility is not well understood. We examined 13 patients with solid bolus dysphagia in a radiologic barium study including, the swallowing of a 14-mm tablet. In all 13 patients the tablet was caught in the proximal or midesophagus. In 8 patients, the entrapment was associated with symptoms (Group 1) whereas in 5 patients (Group 2), no symptoms were reported. All 13 patients together with a control group of 56 healthy, nondysphagic subjects were tested for autonomic nerve function. Autonomic nerve function tests included registration of electrocardiographic R-R interval variation during deep breathing test (E/I ratio), a test of parasympathetic, vagal, nerve function. The results showed that the E/I ratio was significantly lower in patients with symptoms of bolus-specific esophageal dysmotility (-2,19 [1.76]) (median [interquartile range]) compared with patients without symptoms (0.05 [2, 87], p=0.0192) and controls (-0.25 [1.26], p=0.0009). In conclusion, symptomatic bolus-specific esophageal dysmotility is associated with vagal nerve dysfunction.

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Authors and Affiliations

  1. Department of Radiology, University of Lund, Malmö General Hospital, Malmö, Sweden

    Olle Ekberg MD & Rolf Olsson MD

  2. Department of Neurology, University of Lund, Malmö General Hospital, Malmö, Sweden

    Håkan Nilsson MD

  3. Department of Clinical Physiology, University of Lund, Malmö General Hospital, Malmö, Sweden

    Bo Lilia MD

  4. Department of Medicine, University of Lund, Malmö General Hospital, Malmö, Sweden

    Göran Sundkvist MD

Authors
  1. Olle Ekberg MD
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  2. Rolf Olsson MD
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  3. Håkan Nilsson MD
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  4. Bo Lilia MD
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  5. Göran Sundkvist MD
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Ekberg, O., Olsson, R., Nilsson, H. et al. Autonomic nerve dysfunction in patients with bolus-specific esophageal dysmotility. Dysphagia 10, 44–48 (1995). https://doi.org/10.1007/BF00261280

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