A Comparative Study of Esophageal Motility in Diabetics with Neuropathy

Abstract

Ten diabetics with neuropathy had intraluminal esophageal manometric studies. These were compared with a group of controls and a group of diabetics without neuropathy matched for age and sex. Four measurements, ie amplitude of pharyngeal contractions, amplitude of mid-esophageal contractions, conduction time in the body of the esophagus and the lower intrasphincteric resting pressure, were performed in all cases. The results were subjected to statistical analysis. The amplitude of pharyngeal contractions and the resting lower intrasphincteric pressures showed increased responsiveness to normal stimuli in diabetics without neuropathy. Those in whom neuropathy had developed did not demonstrate this effect and tended to parallel controls. An earlier suggestion that the esophagus in diabetics without neuropathy is more responsive to normal stimuli than controls may be substantiated by the observed tendency towards hypofunction seen in two of the measurements carried out in diabetics with neuropathy. It is suggested that transient hypersensitivity to normal stimuli may be the earliest manifestation of diabetic neuropathy in the esophagus.