Purpose: Thyroid disorders are known to be associated with GI tract dysfunction. Hypothyroidism causes alteration of motor function leading to constipation. Hyperthyroidism can be the sole etiology for chronic diarrhea. The exact pathophysiology of alteration in bowel habit due to the effects of hypo or hyperthyroidism is not known, but because of the well-established clinical findings relating thyroid hormone to intestinal motility, TSH has become part of the work up for chronic constipation and diarrhea. However, the effect of thyroid malfunction on esophageal motility is not well known. Our question is that if thyroid function plays an important role in small intestine and colon function, what role, if any, does it play in esophageal motility? We have performed a med-line search of medical literature in English language from 1966 to 2006 and were unable to find a report on esophagus motor dysfunction and thyroid disorders except for one anecdotal case report.The purpose of this study is to assess the subjective prevalence of symptoms related to esophageal motility disorder including dysphagia, GERD and non-cardiac chest pain in thyroid disease.
Methods: 29 consecutive patients with established thyroid disorder in an endocrinology clinic and in a medical clinic were consented and given an IRB approved questionnaire to evaluate the prevalence of subjective esophageal motility disorder symptoms of dysphagia, GERD and NCCP. Consented patients' charts were reviewed for thyroid biochemistries, other medical history and medications. The prevalence of dysphagia, GERD and NCCP in hyper and hypothyroid patients was observed.
Results: 29 (26 women, 3 men, age 26–79) out of 33 consecutive patients (pts) agreed to complete our questionnaire. 16 pts had hypothyrodism, 11 had hyperthyroidism and 2 pts were euthyroid but had goiters.12 of 29 (41%) complained of dysphagia (6/12 solids, 2/12 liquids, 4/12 both). 13 of 29 (44%) had GERD. 7 of 29 (24%) had GERD and dysphagia. 7of 29 (24%) had NCCP. 3 of 29 (10%) had all 3 symptoms. 4 of 29 (13%) pts had GERD and NCCP. None of the 3 men had any of the symptoms. 5 of 16 (31%) hypothyroid pts and 6 of 11 (54%) hyperthyroid pts had dysphagia. 7 of 12 pts with dysphagia were willing to see a GI doctor.
Conclusions: Our study suggests that thyroid disorders may effect esophageal motility. Further investigation using manometry and EGD may be warranted to evaluate the pts with dysphagia and thyroid disease.