Esophageal motility disorders in Mexican patients with Duchenne's muscular dystrophy

Myopathies are entities that mainly involve striated muscle. In Duchenne's muscular dystrophy (DMD) there have been reported smooth muscle alterations in the pre-oral phase of swallowing, in gastric emptying, and pseudoobstruction. Nevertheless, esophageal motility alterations are not concluding. The objective of this work was to determine if there are motor esophageal alterations in this patients, and if this alterations are related to the clinical manifestations of disease.

Nine consecutive patients with DMD (mean age 8, range 6-11 years; males) were evaluated, comparing clinical and manometric findings.

Esophageal manometry alterations were found in all patients, mainly simultaneous non-peristaltic waves (60.86%) of diminished amplitude, in both striated and smooth muscle. Seventy seven percent presented with upper and lower gastrointestinal symptoms (dysphagia, regurgitation, epigastric pain, constipation, and distention). No correlation was found between esophageal motility alterations and gastrointestinal symptoms, nor with the clinical stage of disease in accordance to Brook (r = 0.27).

These results show that patients with DMD present esophageal motor disorders in both striated and smooth muscle, as well as upper and lower gastrointestinal symptoms. Specialized motility studies could yield a better understanding of disease, and, possibly with adequate treatment, provide for a better quality of life in children with DMD.