TY - JOUR
T1 - Idiopathic autonomic denervation in eight patients presenting with functional gastrointestinal disease - A causal association?
AU - Camilleri, M.
AU - Fealey, R. D.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1990/5
Y1 - 1990/5
N2 - Gut dysmotility may result from disease of the extrinsic neural pathways supplying the gut. We report the results of studies on sweating, cardiovascular, and sudomotor reflexes in eight prospectively evaluated patients with apparently functional gastrointestinal disorders. There was no personal or family history of neurologic disease, except for one patient with known atony of the bladder. Motility of the esophagus, stomach, and small intestine were, respectively, abnormal in two, six, and seven patients and showed either uncoordination of contractions between segments or postcibal hypomotility. All had generalized or patchy anhidrosis; quantitative sudomotor axon reflex tests were also abnormal in four patients and borderline in one. Plasma levels of catecholamines were abnormal in one patient. All patients had evidence of sympathetic denervation: preganglionic in two patients, postganglionic in five patients, and mixed in one patient. Three patients also had abnormal heart-rate responses to deep breathing, suggesting parasympathetic dysfunction. No underlying cause for the autonomic dysfunction was identified in any of these patients despite extensive investigations. Thus, these data support the hypothesis that apparently functional gastrointestinal disorders may be due to idiopathic autonomic denervation.
AB - Gut dysmotility may result from disease of the extrinsic neural pathways supplying the gut. We report the results of studies on sweating, cardiovascular, and sudomotor reflexes in eight prospectively evaluated patients with apparently functional gastrointestinal disorders. There was no personal or family history of neurologic disease, except for one patient with known atony of the bladder. Motility of the esophagus, stomach, and small intestine were, respectively, abnormal in two, six, and seven patients and showed either uncoordination of contractions between segments or postcibal hypomotility. All had generalized or patchy anhidrosis; quantitative sudomotor axon reflex tests were also abnormal in four patients and borderline in one. Plasma levels of catecholamines were abnormal in one patient. All patients had evidence of sympathetic denervation: preganglionic in two patients, postganglionic in five patients, and mixed in one patient. Three patients also had abnormal heart-rate responses to deep breathing, suggesting parasympathetic dysfunction. No underlying cause for the autonomic dysfunction was identified in any of these patients despite extensive investigations. Thus, these data support the hypothesis that apparently functional gastrointestinal disorders may be due to idiopathic autonomic denervation.
KW - dysautonomia
KW - functional gastrointestinal disorders
KW - gastrointestinal dysmotility
KW - visceral innervation
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U2 - 10.1007/BF01540409
DO - 10.1007/BF01540409
M3 - Article
C2 - 2331954
AN - SCOPUS:0025368142
SN - 0163-2116
VL - 35
SP - 609
EP - 616
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 5
ER -