Tags

Type your tag names separated by a space and hit enter

Regional differences in the manifestation of gastrointestinal motor disorders in type 1 diabetic patients with autonomic neuropathy.
Z Gastroenterol 2004; 42(11):1295-300ZG

Abstract

OBJECTIVE

The aim of this work was to establish the prevalence and severity of different gastrointestinal symptoms and their relationships to esophageal, gastric and recto-anal motor disturbances by manometry in patients with Type 1 diabetes mellitus and autonomic neuropathy.

PATIENTS AND METHODS

Sixteen patients (mean age: 53.4 +/- 14.9 years) with long standing type 1 diabetes mellitus (mean diabetes duration: 22.1 +/- 14.7 years) and autonomic neuropathy (mean Ewing score: 5.73 +/- 2.34) were investigated. The gastrointestinal symptom scores were established by using the Talley dyspepsia questionnaire. The motor function of the digestive tract was tested in the esophagus, in the stomach, and in the ano-rectum by perfusion manometry.

RESULTS

Manometric evaluation of the esophagus did not reveal significant abnormalities in the region of the upper sphincter in patients with diabetes mellitus. In contrast, diabetic patients had decreased peristaltic wave amplitude, prolonged duration, decreased wave propagation velocity, and increased number of simultaneous contractions in the esophageal body, and decreased lower esophageal sphincter pressures with prolonged relaxation compared to the age- and sex-matched controls. Symptom analysis showed correlations between reflux symptoms and LES relaxation times, and between dysphagia scores and esophageal body peristaltic wave duration, propagation velocity and the rate of simultaneous contractions. In the gastric antrum, frequent, and often severe, fasting motility disorders were observed, which had no correlation with dyspeptic symptoms. In the ano-rectal region the diabetic patients had a lower squeezing-resting pressure difference, and impaired fecal expulsive function. Motility disorders were simultaneously present at multiple parts of the gastrointestinal tract in 13/16 cases.

CONCLUSIONS

In patients with type 1 diabetes mellitus and autonomic neuropathy gastrointestinal motility disorders were observed frequently, and in most of the cases simultaneously. While esophageal and ano-rectal symptoms correlated better with the manometric abnormalities, the lack of correlation between the impaired fasting gastric motility and dyspeptic symptoms shows that, on the basis of the clinical symptom analysis, the prevalence of such motor disorders could be underestimated. The early recognition of gastrointestinal motility disorders may be important for the better long-term management of patients with type 1 diabetes mellitus.

Authors+Show Affiliations

First Department of Medicine, Albert Szent-Györgyi Medical Center, University of Szeged, Hungary.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15558439

Citation

Rosztóczy, A, et al. "Regional Differences in the Manifestation of Gastrointestinal Motor Disorders in Type 1 Diabetic Patients With Autonomic Neuropathy." Zeitschrift Fur Gastroenterologie, vol. 42, no. 11, 2004, pp. 1295-300.
Rosztóczy A, Róka R, Várkonyi TT, et al. Regional differences in the manifestation of gastrointestinal motor disorders in type 1 diabetic patients with autonomic neuropathy. Z Gastroenterol. 2004;42(11):1295-300.
Rosztóczy, A., Róka, R., Várkonyi, T. T., Lengyel, C., Izbéki, F., Lonovics, J., & Wittmann, T. (2004). Regional differences in the manifestation of gastrointestinal motor disorders in type 1 diabetic patients with autonomic neuropathy. Zeitschrift Fur Gastroenterologie, 42(11), pp. 1295-300.
Rosztóczy A, et al. Regional Differences in the Manifestation of Gastrointestinal Motor Disorders in Type 1 Diabetic Patients With Autonomic Neuropathy. Z Gastroenterol. 2004;42(11):1295-300. PubMed PMID: 15558439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional differences in the manifestation of gastrointestinal motor disorders in type 1 diabetic patients with autonomic neuropathy. AU - Rosztóczy,A, AU - Róka,R, AU - Várkonyi,T T, AU - Lengyel,C, AU - Izbéki,F, AU - Lonovics,J, AU - Wittmann,T, PY - 2004/11/24/pubmed PY - 2005/4/1/medline PY - 2004/11/24/entrez SP - 1295 EP - 300 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 42 IS - 11 N2 - OBJECTIVE: The aim of this work was to establish the prevalence and severity of different gastrointestinal symptoms and their relationships to esophageal, gastric and recto-anal motor disturbances by manometry in patients with Type 1 diabetes mellitus and autonomic neuropathy. PATIENTS AND METHODS: Sixteen patients (mean age: 53.4 +/- 14.9 years) with long standing type 1 diabetes mellitus (mean diabetes duration: 22.1 +/- 14.7 years) and autonomic neuropathy (mean Ewing score: 5.73 +/- 2.34) were investigated. The gastrointestinal symptom scores were established by using the Talley dyspepsia questionnaire. The motor function of the digestive tract was tested in the esophagus, in the stomach, and in the ano-rectum by perfusion manometry. RESULTS: Manometric evaluation of the esophagus did not reveal significant abnormalities in the region of the upper sphincter in patients with diabetes mellitus. In contrast, diabetic patients had decreased peristaltic wave amplitude, prolonged duration, decreased wave propagation velocity, and increased number of simultaneous contractions in the esophageal body, and decreased lower esophageal sphincter pressures with prolonged relaxation compared to the age- and sex-matched controls. Symptom analysis showed correlations between reflux symptoms and LES relaxation times, and between dysphagia scores and esophageal body peristaltic wave duration, propagation velocity and the rate of simultaneous contractions. In the gastric antrum, frequent, and often severe, fasting motility disorders were observed, which had no correlation with dyspeptic symptoms. In the ano-rectal region the diabetic patients had a lower squeezing-resting pressure difference, and impaired fecal expulsive function. Motility disorders were simultaneously present at multiple parts of the gastrointestinal tract in 13/16 cases. CONCLUSIONS: In patients with type 1 diabetes mellitus and autonomic neuropathy gastrointestinal motility disorders were observed frequently, and in most of the cases simultaneously. While esophageal and ano-rectal symptoms correlated better with the manometric abnormalities, the lack of correlation between the impaired fasting gastric motility and dyspeptic symptoms shows that, on the basis of the clinical symptom analysis, the prevalence of such motor disorders could be underestimated. The early recognition of gastrointestinal motility disorders may be important for the better long-term management of patients with type 1 diabetes mellitus. SN - 0044-2771 UR - https://www.unboundmedicine.com/medline/citation/15558439/Regional_differences_in_the_manifestation_of_gastrointestinal_motor_disorders_in_type_1_diabetic_patients_with_autonomic_neuropathy_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2004-813618 DB - PRIME DP - Unbound Medicine ER -