Esophageal motility in children with Hirschsprung's disease
A. Staiano, E. Corazziari, M. R. Andreotti and R. E. Clouse
Department of Pediatrics, II School of Medicine, University of Naples, Italy.
Esophageal motility was studied in 12 children with Hirschsprung's disease
to see if extracolonic motor dysfunction was present in this disorder.
Manometric tracings were compared with those from eight children with
idiopathic megacolon and from 10 children without esophageal disease or
constipation. Amplitude of esophageal contraction waves was significantly
higher in children with Hirschsprung's disease than in the other two
groups. Swallows that were followed by simultaneous contractions or
double-peaked waves were also more common in the group with Hirschsprung's
disease (subjects with Hirschsprung's disease, subjects with megacolon, and
controls; 57%, 10%, and 8%, respectively). Lower esophageal sphincter
characteristics did not differ among the three groups. The increase in
simultaneous contractions and double-peaked waves persisted in those
children who were reexamined following surgery for Hirschsprung's disease,
whereas wave amplitudes fell to a level similar to that observed in the
other groups. These data suggest that gastrointestinal motor dysfunction in
persons with Hirschsprung's disease is not restricted to the colon, and
that some of the observed abnormalities in esophageal motility do not
reflect nonspecific responses to megacolon or colonic obstruction.
