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Endocrine Abstracts (2014) 35 OC1.1 | DOI: 10.1530/endoabs.35.OC1.1

1Endocrinology Department, Bezmialem Vakif University, Istanbul, Turkey; 2Gastroenterology Department, Bezmialem Vakif University, Istanbul, Turkey.


Introduction: Gastrointestinal tract is one of the most affected systems in hypothyroidism. The most plausible mechanism in the pathogenesis is the development of interstitial edema subsequent to accumulation of glycosaminoglycans. Despite decreased esophageal emptying, prolonged esophageal and gastric transit time has been indicated in previous reports, the mechanism of thyroid hormones activity on the gastrointestinal system is not yet fully understood. To our knowledge, this is the first prospective study conducted to evaluate esophagus motility by manometry in hypothyroid patients.

Methods: The study enrolled with 28 overt, newly diagnosed hypothyroid patients and 29 age-sex matched healthy controls. Twenty-one females and 7 males (mean age: 46.9 years, range 23–76 years) with overt hypothyroidism and 22 females and 7 males (mean age: 45.0 years, range 19–77 years) with healthy control subjects were recruited to study. Esophageal manometry was performed using MMS (Medical Measurement Systems bv. The Netherlands) Solar GI - Air Charged Intelligent Gastrointestinal Conventional Manometry.

Results: In manometric measurements, LESP (lower esophageal sphincter pressure) was 19.5±6.5 mmHg in hypothyroid patients and 17.48±4.65 mmHg in controls and there was no significant difference (P=0.18). Percentage of relaxation was 61.5% and 80.9% and it was significantly lower in hypothyroid patients than controls (P<0.001). Additionally, duration of relaxation was found 3.85±2.3 and 5.5±2.28 s in patients and controls, respectively (P=0.009). In patient group, LESP was positively correlated with fT3 (P=0.033) and the duration of the contraction was negatively correlated with fT4 (P=0.044).

Conclusion: In this study we observed that hypothyroid state can affect esophagus motility via shortened duration of relaxation and reduced percentage of relaxation. Hypothyroid patients should be questioned and explored for esophageal symptoms. Further studies are needed to clarify the effect of thyroid hormones and thyroid antibodies on esophagus motility.

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