Lowered sympathetic reactivity in patients with non-bleeding duodenal ulcers.

BACKGROUND

Autonomic dysfunction has been associated with duodenal ulcer. We assessed autonomic reactivity in patients with duodenal ulcer.

METHODS

Ten patients with non-bleeding active duodenal ulcers and ten age- and sex-matched healthy subjects were investigated for parasympathetic reactivity (heart rate response to deep breathing, Valsalva maneuver and head-up tilt test) and sympathetic reactivity (blood pressure response to hand grip, head-up tilt and cold pressor test). Anxiety status was measured by evaluating responses to a questionnaire.

RESULTS

The duodenal ulcer patients showed normal parasympathetic reactivity, lowered sympathetic reactivity and high anxiety score. When compared to control subjects, they had significantly lower diastolic blood pressure change in response to hand grip (median [range]; difference in values 12 [4-16] mmHg vs 16 [10-22] mmHg) and head up tilt (1 [-6-4] vs 6 [2-10] mmHg).

CONCLUSIONS

Patients with duodenal ulcer have lowered sympathetic reactivity; this may be involved in causation by decreasing mucosal protection.