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Abnormal esophagocardiac inhibitory reflex in patients with diffuse esophageal spasm
M Bortolotti1, P Sarti, F Brunelli
11st Medical Clinic, University of Bologna, Italy.
Digestion
|January 1, 1995
Summary
Patients with diffuse esophageal spasm exhibit a heightened esophagocardiac reflex during swallowing and esophageal distension. This exaggerated reflex may increase the risk of cardiac arrhythmias in susceptible individuals.
Area of Science:
- Gastroenterology
- Cardiology
- Physiology
Background:
- Swallow syncope is linked to esophageal dysmotility and esophagocardiac reflexes.
- Diffuse esophageal spasm (DES) involves esophageal motility disorders.
Purpose of the Study:
- To investigate if patients with DES have a pathologic esophagocardiac reflex.
- To compare reflex responses in normal subjects and DES patients.
Main Methods:
- Simultaneous electrocardiogram (ECG) and intraesophageal pressure recording.
- Studied effects of dry swallows, solid bolus ingestion, and intraesophageal balloon distension.
- Compared responses in 8 healthy volunteers and 10 DES patients.
Main Results:
- Solid bolus ingestion caused a more pronounced heart rate increase followed by a decrease in DES patients compared to controls.
- Intraesophageal balloon inflation induced a significantly more intense heart rate decrease in DES patients.
- Esophageal distension elicits an inhibitory esophagocardiac reflex, more intense in DES.
Conclusions:
- Diffuse esophageal spasm patients exhibit an exaggerated inhibitory esophagocardiac reflex.
- Esophageal distension can trigger this reflex, potentially leading to cardiac arrhythmias in predisposed individuals.