RESUMEN
Gastrointestinal tract and especially the esophagus is frequently involved in neurological disorders; however, objective studies of gut motor functions are few. To report on the esophageal motility in idiopathic Parkinson's disease [IPD] with age-and sex-matched controls in order to evaluate the swallowing function. To correlate the objective findings with subjective symptoms, age, duration and severity of the disease including the clinical extrapyramidal function assessment. The following studies were performed on twenty idiopathic Parkinson's disease patients with age and sex matched controls: extrapyramidal function assessment using Unified Parkinson's Disease Rating Scale [UPDRS], gastrointestinal [GI] symptom survey and esophageal manometry. Clinical assessment showed that the most common gastrointestinal [GI] symptoms encountered were sialorrhea [55%] followed by constipation [31%] and dysphagia [30%]. However, manometric abnormalities were documented in 65% of cases and were presented by weak esophageal body contraction in all of them, high upper esophageal sphincter pressure [UESP] in 7 cases [35%] and reduced lower esophageal sphincter pressure [LESP] in 6 cases [30%]. Statistical analysis of data revealed inverse correlation between the severity of tremors and UESP as well as LESP [r =-0.636 and -0.767 respectively]. On the other hand, the degree of rigidity showed a significant positive correlation with the upper and lower esophageal sphincter pressure [r = 0.658 and 0.585 respectively], while significant negative correlation between the lower esophageal sphincter relaxation and the amplitude of esophageal body contraction. No significant correlation was found between manometric findings versus age, duration of illness as well as staging of the disease. Esophageal motility dysfunction appears to be an early GI manifestation of IPD and may represent direct involvement of the gut by this disease process