Esophagitis and esophageal motor abnormalities in patients with chronic spinal cord injuries

To investigate the frequency and severity of esophagitis and esophageal dysmotility in patients with chronic spinal cord injury (SCI), 46 males with chronic SCI completed a questionnaire regarding gastrointestinal symptomatology. Eleven of these patients subsequently underwent upper gastrointestinal (GI) endoscopy with esophageal biopsies and 10 of the 11 also had esophageal motility studies. A significantly higher percentage of SCI patients experienced heartburn (SCI 61%; controls (C) 40%), esophageal chest pain (SCI 33%; C 6.4%), and intermittent dysphagia (SCI 30%; C 8.5%). Forty-five percent of SCI patients had endoscopic evidence of mild esophagitis, and 91% of them had histologic evidence of esophagitis. SCI patients had low amplitude, slowly propagating abnormal (double-peaked) peristatic esophageal contractions. We conclude that SCI patients experience significantly more esophageal symptoms than controls. They have a higher incidence of esophagitis and esophageal motor abnormalities. The clinical relevance of these abnormalities remains to be evaluated.