PATTERNS OF ESOPHAGEAL MOTILITY IN PATIENTS WITH STABLE BULIMIA

Objectives: A high prevalence of GI motility disturbances, including d eranged esophageal motility, has previously been reported in patients with eating disorders; altered esophageal and gastric motility have be en suggested to play an important role in these disease processes. We sought to confirm this association in an independent patient populatio n. Methods: We performed esophageal manometry in 12 patients with eati ng disorders (eight patients with bulimia and four with overlap syndro mes, including both anorexia and bulimia features) and 12 sex-matched controls. All subjects completed a symptom questionnaire. Motility tes ting was performed in the standard fashion using a low compliance wate r perfusion catheter and computerized digital data capture. Coded trac ings were interpreted in a blinded fashion. Results: All 24 studies sh owed normal motility patterns [95% confidence interval for abnormal es ophageal motility in eating disorders patients (0, 0.27)]. Mean lower esophageal sphincter pressure was 24.4 mm Hg in patients and 21.8 in c ontrols; all relaxed normally. Mean esophageal body contraction amplit ude 3 cm above the lower esophageal sphincter was 82.6 mm Hg in patien ts and 84.3 in controls; waveform morphology and progression met norma l criteria in all studies. Eight of 12 patients reported dysphagia, od ynophagia, or both, compared with 1 of 12 controls; patients demonstra ted a pattern of increased overall GI symptomatology compared to contr ols. Conclusions: We conclude that disordered esophageal motility is u ncommon among stable eating disorder outpatients with bulimic features , and that dysphagia and odynophagia are rarely associated with disord ered motility in this group.