Oesophageal dysmotility in diabetic patients with varices

ABSTRACT

Complications involving the gastrointestinal tract are important causes of morbidity in cirrhotic patients with diabetes mellitus. Our aim was to study the possible influences of varices on oesophageal motility in diabetic patients. A total of 40 diabetic patients were recruited into two groups group 119 patients without varices; group 2 21 patients with varices. Twenty healthy volunteers were selected as control. Oesophageal manometry was performed for patients and control subjects. In comparison to control subjects, group 1 had lower residual pressure with incomplete relaxation of the lower oesophageal sphincter [LES] [p wave duration and lower velocity in the distal oesophagus [p=0.014 and 0.028] and lower wave velocity in the proximal oesophagus [<0.001]; group 2 had lower resting and residual pressures with incomplete LES relaxation [p=0.01, <0.001 and <0.001, respectively]. Lower wave amplitude, longer duration and lower velocity in the distal oesophagus [p=0.002, 0.004 and <0.001], lower wave amplitude and lower velocity in the proximal oesophagus [all p<0.0001] and more frequent abnormal waves [p = 0.005]. Lastly, group 2 had lower resting LES pressure than group 1 patients [p=0.042]. Among patients with diabetes and varices, changes in oesophageal motility are common but, with the exception of lower oesophageal sphincter hypotension, are related to diabetes rather than to the presence of varices