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Achalasia: A vagal disease

Ohlsson, Bodil LU ; Ekberg, Olle LU and Sundkvist, Göran LU (2004) In Scandinavian Journal of Gastroenterology 39(6). p.527-530
Abstract
Background: Achalasia is considered to be a primary motor disorder of the oesophagus. However, there is increasing evidence to suggest extra- oesophageal involvement in this disease. Vagal disturbances at different levels and extra- oesophageal dysmotility have been reported in several studies. The aim of this study was to examine cardiovascular reflexes in patients with achalasia further to evaluate the involvement of the autonomic nervous system outside the oesophagus in this entity. Methods: Five patients ( age range 38 - 58 years, median 45 years) diagnosed with achalasia were assessed for the autonomic nerve function by the heart rate reaction to deep breathing ( E/ I ratio) and to tilt ( acceleration and brake index). The blood... (More)
Background: Achalasia is considered to be a primary motor disorder of the oesophagus. However, there is increasing evidence to suggest extra- oesophageal involvement in this disease. Vagal disturbances at different levels and extra- oesophageal dysmotility have been reported in several studies. The aim of this study was to examine cardiovascular reflexes in patients with achalasia further to evaluate the involvement of the autonomic nervous system outside the oesophagus in this entity. Methods: Five patients ( age range 38 - 58 years, median 45 years) diagnosed with achalasia were assessed for the autonomic nerve function by the heart rate reaction to deep breathing ( E/ I ratio) and to tilt ( acceleration and brake index). The blood pressure reaction to tilt was also assessed. The results were compared with a control group comprising 56 healthy individuals ( age range 16 - 59 years, median 40 years). Results: Patients with achalasia had a significantly decreased E/ I ratio compared with controls ( absolute values 1.13 ( 0.23) ( median value ( interquartile range)) versus 1.38 ( 0.14): P = 0.0309, age corrected values - 1.39 ( 1.49) versus - 0.25 ( 1.20): P = 0.0457). This reflects impairment of the vagus nerve. In contrast, sympathetic nerves were not affected, as the acceleration index and brake index and postural blood pressure reaction were not disturbed in patients. Conclusion: Patients with achalasia have autonomic nerve dysfunction in the vagal nerve outside the oesophagus. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
vagus, achalasia, neuropathy
in
Scandinavian Journal of Gastroenterology
volume
39
issue
6
pages
527 - 530
publisher
Taylor & Francis
external identifiers
  • wos:000222222200005
  • pmid:15223675
  • scopus:3142662769
ISSN
1502-7708
DOI
10.1080/00365520410004460
language
English
LU publication?
yes
id
0e348098-ea60-40fa-bc44-a8251d5f765c (old id 898858)
date added to LUP
2008-01-18 10:23:50
date last changed
2017-10-29 04:19:33
@article{0e348098-ea60-40fa-bc44-a8251d5f765c,
  abstract     = {Background: Achalasia is considered to be a primary motor disorder of the oesophagus. However, there is increasing evidence to suggest extra- oesophageal involvement in this disease. Vagal disturbances at different levels and extra- oesophageal dysmotility have been reported in several studies. The aim of this study was to examine cardiovascular reflexes in patients with achalasia further to evaluate the involvement of the autonomic nervous system outside the oesophagus in this entity. Methods: Five patients ( age range 38 - 58 years, median 45 years) diagnosed with achalasia were assessed for the autonomic nerve function by the heart rate reaction to deep breathing ( E/ I ratio) and to tilt ( acceleration and brake index). The blood pressure reaction to tilt was also assessed. The results were compared with a control group comprising 56 healthy individuals ( age range 16 - 59 years, median 40 years). Results: Patients with achalasia had a significantly decreased E/ I ratio compared with controls ( absolute values 1.13 ( 0.23) ( median value ( interquartile range)) versus 1.38 ( 0.14): P = 0.0309, age corrected values - 1.39 ( 1.49) versus - 0.25 ( 1.20): P = 0.0457). This reflects impairment of the vagus nerve. In contrast, sympathetic nerves were not affected, as the acceleration index and brake index and postural blood pressure reaction were not disturbed in patients. Conclusion: Patients with achalasia have autonomic nerve dysfunction in the vagal nerve outside the oesophagus.},
  author       = {Ohlsson, Bodil and Ekberg, Olle and Sundkvist, Göran},
  issn         = {1502-7708},
  keyword      = {vagus,achalasia,neuropathy},
  language     = {eng},
  number       = {6},
  pages        = {527--530},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Achalasia: A vagal disease},
  url          = {http://dx.doi.org/10.1080/00365520410004460},
  volume       = {39},
  year         = {2004},
}