Relationship between esophageal dysfunction and neuropathy in diabetic patients

Kinekawa, Fumihiko; Kubo, Fumiyoshi; Matsuda, Kazuya; Fujita, Youko; Tomita, Tadataka; Uchida, Yuzo; Nishioka, Mikio

doi:10.1016/s0002-9270(01)02425-x

Cited by 23 publications

(13 citation statements)

References 29 publications

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“…A diagnosis of diabetic autonomic neuropathy with airway reflux cough was made. There is a reported higher prevalence of abnormal gastro-oesophageal reflux (GOR) among the asymptomatic diabetic population [6], with the existence of cardiovascular autonomic neuropathy, and there is a significant correlation between abnormal acid reflux and diabetic motor neuropathy [7]. Diabetic autonomic neuropathy presenting with an isolated cough possibly secondary to airways reflux has not been reported previously.…”

Section: Case 3: Diabetic Autonomic Neuropathymentioning

confidence: 97%

“…In a recent multicentre study of 226 consecutive patients with idiopathic or familial PAH, the combined use of baseline values for peak oxygen uptake and pulmonary vascular resistance (PVR) provided a more comprehensive prognostic assessment than either parameter alone [6]. Taking the concept a step further, two independent risk scores that combine multiple clinical parameters to predict prognosis have been developed [7,8]. In a recent single centre, retrospective study that independently validated the REVEAL (Registry to Evaluate Early and Long-Term PAH Disease Management) score [8], it was shown that assessment of the REVEAL prediction score in addition to FC enhanced prediction of…”

Section: To the Editormentioning

confidence: 99%

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Neurological conditions presenting as airway reflux cough

et al. 2012

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Section: Case 3: Diabetic Autonomic Neuropathymentioning

confidence: 97%

Section: To the Editormentioning

confidence: 99%

Neurological conditions presenting as airway reflux cough

et al. 2012

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“…The lower LES pressure with impaired relaxation allows gastric contents to reflux into the esophagus. Furthermore, decreased esophageal motility results in a prolonged transit time, decreased clearance of refluxed acid, and increased exposure to acid, leading to GERD symptoms . Therefore, DM‐induced esophageal changes are associated with GERD, and treatment must be planned in accordance with this.…”

Section: Clinical Consequences Of Diabetes‐induced Changes In the Esomentioning

confidence: 99%

Diabetes‐induced mechanophysiological changes in the esophagus

Zhao

Gregersen

2016

Annals of the New York Academy of Sciences

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Esophageal disorders are common in diabetes mellitus (DM) patients. DM induces mechanostructural remodeling in the esophagus of humans and animal models. The remodeling is related to esophageal sensorimotor abnormalities and to symptoms frequently encountered by DM patients. For example, gastroesophageal reflux disease (GERD) is a common disorder associated with DM. This review addresses diabetic remodeling of esophageal properties and function in light of the Esophagiome, a scientifically based modeling effort to describe the physiological dynamics of the normal, intact esophagus built upon interdisciplinary approaches with applications for esophageal disease. Unraveling the structural, biomechanical, and sensory remodeling of the esophagus in DM must be based on a multidisciplinary approach that can bridge the knowledge from a variety of scientific disciplines. The first focus of this review is DM-induced morphodynamic and biomechanical remodeling in the esophagus. Second, we review the sensorimotor dysfunction in DM and how it relates to esophageal remodeling. Finally, we discuss the clinical consequences of DM-induced esophageal remodeling, especially in relation to GERD. The ultimate aim is to increase the understanding of DM-induced remodeling of esophageal structure and sensorimotor function in order to assist clinicians to better understand the esophageal disorders induced by DM and to develop better treatments for those patients.

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“…The myenteric plexus innervates the smooth muscles of the distal esophagus and LES. Neuropathy from long‐standing diabetes can affect the myenteric plexus leading to esophageal dysmotility . In T2DM patients, esophageal dysmotility can occur with or independent of diabetic peripheral neuropathy .…”

Section: Esophageal Dysmotility In Diabeticsmentioning

confidence: 99%

“…In a study comparing esophageal manometry of healthy individuals with that of diabetic patients, mechanisms of dysmotility observed included: (i) a decrease in effective peristalsis; (ii) a decrease in velocity and duration of peristaltic waves, especially in the distal esophagus; (iii) lower LES pressure; and (iv) an increase in multipeaked contractions . Decreased esophageal motility results in a prolonged transit time, decreased clearance of refluxed acid, and increased exposure to and/or contact time of acid that lead to symptoms of GERD . Diabetic patients with neuropathy often have altered pain perceptions resulting in a higher prevalence of asymptomatic erosive esophagitis .…”

Section: Esophageal Dysmotility In Diabeticsmentioning

confidence: 99%

Review of gastroesophageal reflux disease (GERD) in the diabetic patient

Punjabi

Hira

Prasad

et al. 2015

Journal of Diabetes

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This article reviews the known pathophysiological mechanisms of comorbid gastroesophageal reflux disease (GERD) in the diabetic patient, discusses therapeutic options in care, and provides an approach to its evaluation and management. We searched for review articles published in the past 10 years through a PubMed search using the filters diabetes mellitus, GERD, pathophysiology, and management. The search only yielded a handful of articles, so we independently included relevant studies from these review articles along with related citations as suggested by PubMed. We found diabetic patients are more prone to developing GERD and may present with atypical manifestations. A number of mechanisms have been proposed to elucidate the connection between these two diseases. Studies involving treatment options for comorbid disease suggest conflicting drug-drug interactions. Currently, there are no published guidelines specifically for the evaluation and management of GERD in the diabetic patient. Although there are several proposed mechanisms for the higher prevalence of GERD in the diabetic patient, this complex interrelationship requires further research. Understanding the pathophysiology will help direct diagnostic evaluation. In our review, we propose a management algorithm for GERD in the diabetic patient.

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Relationship between esophageal dysfunction and neuropathy in diabetic patients

Cited by 23 publications

References 29 publications

Neurological conditions presenting as airway reflux cough

Neurological conditions presenting as airway reflux cough

Diabetes‐induced mechanophysiological changes in the esophagus

Review of gastroesophageal reflux disease (GERD) in the diabetic patient

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