ESOPHAGITIS AND ESOPHAGEAL MOTOR ABNORMALITIES IN PATIENTS WITH CHRONIC SPINAL-CORD INJURIES

To investigate the frequency and severity of esophagitis and esophagea l dysmotility in patients with chronic spinal cord injury (SCI), 46 ma les with chronic SCI completed a questionnaire regarding gastrointesti nal symptomatology. Eleven of these patients subsequently underwent up per gastrointestinal (GI) endoscopy with esophageal biopsies and 10 of the 11 also had esophageal motility studies. A significantly higher p ercentage of SCI patients experienced heartburn (SCI 61%; controls (C) 40%), esophageal chest pain (SCI 33%; C 6.4%), and intermittent dysph agia (SCI 30%; C 8.5%). Forty-five percent of SCI patients had endosco pic evidence of mild esophagitis, and 91% of them had histologic evide nce of esophagitis. SCI patients had low amplitude, slowly propagating abnormal (double-peaked) peristatic esophageal contractions. We concl ude that SCI patients experience significantly more esophageal symptom s than controls. They have a higher incidence of esophagitis and esoph ageal motor abnormalities. The clinical relevance of these abnormaliti es remains to be evaluated.