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Abstract

Although hypo- and hyperthyroid patients have different symptoms in the gastrointestinal tract, the mechanism of thyroid action on the gut remains poorly understood. Thus the aim of this study was to investigate the effect of hypo- and hyperthyroidism on gastric myoelectrical activity, gastric emptying, dyspeptic symptoms. Twenty-two hyperthyroid (median age 45, 15 females) and 11 hypothyroid (median age 42, 10 females) patients were included into the study. Dyspepsia score, hypo- and hyperthyroid symptom scale, abdominal ultrasonography and upper gastrointestinal endoscopy were performed. Gastric myoelectrical activity was measured by electrogastrograpy (EGG) before and after therapy both preprandially and postprandially and compared with age, gender, and body-matched controls (12 for hypothyroid, 15 for hyperthyroid patients). Radionuclide gastric emptying studies were performed with a solid meal. Hypothyroid patients revealed a significant increase in preprandial tachygastria as compared with controls (12.3% vs 4.8%). The percentage of preprandial normal slow waves (2.4-3.7 cpm) was below 70% (dysmotility) in 7 of 11 hypothyroid patients versus 2 of 12 controls (P < 0.05). Hyperthyroid patients revealed a significantly higher preprandial (3.1 vs 2.8) and postprandial (3.4 vs 3) DF when compared with the controls (P < 0.05). A higher percentage of postprandial taschygastria (7.9 vs 0) was present in hyperthyroid patients than in the controls (P < 0.05). The decrease on postprandial EGG power (power ratio < 1) was observed in 7 patients the in hyperthyroid group and 1 in controls (P < 0.05). The percentage of postprandial normal slow waves was below 70% in 10 of 20 hyperthyroid patients vs 1 of 15 controls (P < 0.05). After therapy these differences disappeared in the euthyroid state. The hypo- and hyperthyroid symptom scale correlated to dyspepsia score. Dyspepsia score in hyperthyroidism correlated to power ratios in hyperthyroid patients. We detected some correlations between serum levels of fT3 or fT4 and some EGG parameters in hypo- and hyperthyroidism. Dyspepsia score and hypo- and hyperthyroid symptom scale were improved significantly after therapy in the euthyroid state. In conclusions, we showed gastric dysrhythmia by EGG in both hypo- and hyperthyroid patients. Dyspeptic symptoms correlated to the activity of thyroid disease. After therapy, these findings and dyspeptic symptoms improved in the euthyroid state. Abnormalities of power ratios may be responsible of dyspeptic symptoms in hyperthyroid patients. EGG may be a useful and noninvasive tool for detecting gastric disturbances during hypo- and hyperthyroidism.

Does Hypothyroidism Affect Gastrointestinal Motility?

“…There have been reports of disorders of motility and transport functions in the digestive system resulting from hypothyroidism [1, 2]. A reduction in the motor activity of stomach, small intestine, and colon has been reported in previous studies.…”

“…Delayed intestinal transit time has been reported for hypothyroid patients, although normal gastric emptying time and normal intestinal transit time have also been reported for sufferers of thyroid disorders [1–7]. There have been a few esophageal motility and gastric emptying rate studies performed, but the pathophysiology of changes in the motor activity of digestive system observed in hypothyroid patients has not yet been determined [2, 7]. The most probable pathological reason is the intestinal edema due to mucopolysaccharide accumulation in gastrointestinal tissue, especially hyaluronic acid [7].…”

Asian Consensus Report on Functional Dyspepsia

“…Many organic, systemic or metabolic conditions such as peptic ulcer diseases, cancers of the GI and hepatobiliary tract,9,10 parasitic infestations,11-14 chronic pancreatic diseases,15 hyperand hypothyroidisms,16 chronic renal failures,17 and electrolyte imbalances, as well as medications, can produce symptoms similar to FD and should be considered before making a diagnosis of FD.…”

“…Most consensus members agreed that, if clinically indicated, complete blood count and blood biochemistry tests including tests for creatinine,17 electrolytes, sugar, thyroid function16 and liver function are useful for identifying underlying causes that may produce dyspeptic symptoms (Fig. 1).…”

Inhibitory effect of aluminium on calcium absorption in small intestine of rats with different thyroid hormone status

“…Hyperthyroid patients often reveal dyspeptic symptoms [16], and then it is feasible that these patients ingest aluminium-based compounds to ameliorate their gastric symptoms.…”