Esophageal contractions and oropharyngeal and esophageal transits in patients with iron deficiency anemia

Abstract

Objective Patients with iron deficiency may have reduced power of the pharyngeal muscle for bolus propulsion into the esophagus. We hypothesized that esophageal muscle is similarly impaired. Methods We studied the oropharyngeal and esophageal transits and esophageal motility of 12 patients (11 women) aged 31–50 yr (median 36 yr) with iron deficiency anemia (serum iron less than 40 μg/dl) and 17 normal volunteers (16 women) aged 26–52 yr (median 37 yr) with serum iron greater than 60 μg/dl. The esophageal motility was studied by the manometric method, with continuous perfusion and 10 swallows of a 2-ml bolus of water alternated with 10 swallows of a 7-ml bolus; and the oropharyngeal and esophageal transits were studied by scintigraphy, with swallows of a 10-ml bolus for the study of oropharyngeal transit and of a 10-ml bolus for the study of esophageal transit. Motility and transit were studied in the supine position. Results The amplitude, duration and area under the curve of contractions were lower in patients than in volunteers. There were no differences in peristaltic contraction velocity, lower esophageal sphincter pressure, and lower esophageal sphincter relaxation duration. There was no difference in oropharyngeal transit. In the esophagus the transit was slower in patients than in volunteers. The time needed by the scintigraphic activity to reach a peak in the proximal esophagus was longer in patients than in volunteers. Conclusions Iron deficiency may decrease esophageal contractions and impair esophageal transit.