Multiple Sclerosis Is Associated With Achalasia and Diffuse Esophageal Spasm

Area of Science:

• Neurology
• Gastroenterology
• Immunology

Background:

• Multiple sclerosis (MS) is a central nervous system inflammatory disease causing demyelination.
• Diffuse esophageal spasm (DES) and achalasia are esophageal motility disorders causing dysphagia.
• Myenteric plexus nerve fiber dysfunction is a proposed mechanism for these esophageal disorders.

Purpose of the Study:

• To investigate if multiple sclerosis (MS) increases the risk of developing achalasia or diffuse esophageal spasm (DES).

Main Methods:

• A cohort analysis was conducted using the Explorys database.
• Univariate logistic regression determined the odds of MS associated with achalasia and DES.
• Dysautonomia comorbidities were compared across patient cohorts, excluding specific conditions like diabetes and Chagas' disease.

Main Results:

• MS patients had significantly higher odds of developing achalasia (OR, 2.09) and DES (OR, 3.15).
• Higher rates of dysautonomia comorbidities including urinary incontinence, gastroparesis, impotence, and insomnia were observed in MS patients with achalasia or DES compared to those without.

Conclusions:

• Multiple sclerosis (MS) is associated with an elevated risk of achalasia and diffuse esophageal spasm (DES).
• MS patients with these esophageal disorders show increased dysautonomia, suggesting a more severe phenotype of neuronal damage and demyelination.