Autonomic dysfunction in gastrointestinal motility disorders

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Abstract

The records of 113 consecutive patients with a suspected gastrointestinal motility disorder referred between January 1988 and July 1991 were retrospectively reviewed. The aims were to identify the prevalence of autonomic dysfunction in those with or without associated neurological disease and to determine the diagnostic value of testing for autonomic dysfunction. All patients had gastrointestinal manometry (3 hours fasting, 2 hours fed), 94 of 113 underwent testing of sympathetic adrenergic and cholinergic function and cardiovagal cholinergic function. All tests were scored in a standard manner. There was a significant (p < 0.05) but modest (r = 0.28) rank correlation between autonomic and motility scores. This correlation was stronger (r = 0.67, p = 0.01) in diabetic patients. The number of patients in each group with autonomic dysfunction was as follows: irritable bowel syndrome nine of 33, idiopathic upper gastrointestinal dysmotility six of 21, diabetes mellitus nine of 13 identified non-diabetic neurological syndromes six of nine, postvagotomy or abdominal surgery three of 11, and myopathic pseudo-obstruction two of seven. Autonomic testing is useful in the assessment of autonomic involement outside the gastrointestinal tract. Logistic discriminant analysis showed that autonomic function testing did not add to the diagnostic value of motility tests in distinguishing between patients with and without irritable bowel syndrome, although a slight improvement was indicated for identifying neruopathic dysmotilities. Thus, the aetiological role of general autonomic dysfunction in irritable bowel syndrome and idiopathic and postvagotomy dysmotilities deserves further study. The addition of autonomic function tests does not add substantially to the diagnostic accuracy of clinical, radiological, endoscopic, and manometric techniques in most patients referred for evaluation of a suspected motility disorder.

Original languageEnglish (US)
Pages (from-to)397-401
Number of pages5
JournalGut
Volume34
Issue number3
StatePublished - 1993

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Gastrointestinal Motility
Irritable Bowel Syndrome
Cholinergic Agents
Manometry
Discriminant Analysis
Adrenergic Agents
Gastrointestinal Tract
Fasting
Diabetes Mellitus

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Autonomic dysfunction in gastrointestinal motility disorders. / Bharucha, Adil Eddie; Camilleri, Michael; Low, Phillip Anson; Zinsmeister, A. R.

In: Gut, Vol. 34, No. 3, 1993, p. 397-401.

Research output: Contribution to journalArticle

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