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Autonomic dysfunction in patients with achalasia

V F Eckardt¹, F Stenner, H Liewen

¹Gastroenterologisches Institut Wiesbaden, Universität Mainz, Germany.

Neurogastroenterology and Motility

|March 1, 1995

Summary

Patients with achalasia often have gastrointestinal issues and may also experience autonomic nervous system dysfunction. This study found abnormalities in cardiovascular and neurohormonal functions in achalasia patients beyond the GI tract.

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Area of Science:

Gastroenterology
Neurology
Autonomic Function Testing

Background:

Achalasia is associated with gastrointestinal motor abnormalities.
Previous research suggests potential involvement of the autonomic nervous system.

Purpose of the Study:

To investigate extraintestinal autonomic nervous system function in patients with achalasia.
To determine if autonomic dysfunction extends beyond the gastrointestinal tract in achalasia.

Main Methods:

Autonomic function tests including pupillography and cardiovascular studies (heart rate variation, blood pressure response to stimuli).
Neurohormonal assessment via serum pancreatic polypeptide (PP) levels after sham feeding.
Comparison between 15 achalasia patients and 15 healthy controls.

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Main Results:

No significant difference in pupillary function between groups.
Abnormal autonomic cardiovascular responses were observed in 9 of 15 achalasia patients (60%), significantly more than controls (P = 0.023).
Impaired pancreatic polypeptide response to sham feeding was noted in more achalasia patients than controls.

Conclusions:

Patients with achalasia can exhibit autonomic nervous system abnormalities outside the gastrointestinal tract.
These extraintestinal autonomic dysfunctions primarily affect cardiovascular regulation and may involve neurohormonal pathways.