Esophageal dysfunction in diabetic neuropathy-gastroenteropathy. Clinical and roentgenological manifestations

The literature is almost totally devoid of data concerning esophageal pathology and dysfunction in diabetes mellitus. Cineradiographic examination of the esophagus in 14 patients with evidence of neuropathy-gastroenteropathy revealed evidence of dysfunction in 12, manifested chiefly by absence or diminution of the primary peristaltic wave, presence of tertiary contractions, and marked delay in esophageal emptying with the patient in the recumbent position. No patient showed difficulty in the initiation of swallowing or any regurgitation of barium sulfate from the esophagus into the pharynx. In marked contrast to the high cineradiographic incidence of dysfunction, symptoms referable to the esophagus were present in only three patients and were severe in only two. This study makes clear that esophageal motor dysfunction is a common finding in diabetic neuropathy-gastroenteropathy and that it results, on occasion, in dysphagia.