Document Detail


Effect of lower esophageal sphincter tone and crural diaphragm contraction on distensibility of the gastroesophageal junction in humans.
MedLine Citation:
PMID:  15361362     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies of distensibility of the gastroesophageal junction (GEJ) in humans have not tried to distinguish between the effects of muscle action and passive elastic tissue properties of the GEJ. We studied 15 healthy subjects (ages 23-67 yr, 11 men/4 women) by using a catheter with a highly complaint bag positioned manometrically at the GEJ. The bag was distended with air at a rate of 20 ml/min while intrabag pressure was recorded. Distensions were performed during normal breathing, with breath held at maximum inspiration (MI) to activate the diaphragmatic crura, and with midesophageal balloon distension (BD) to relax the lower esophageal sphincter. In 10 subjects, distensions were performed after atropine injection (12 microg/kg iv). Pressure-volume curves and incremental distensibility values were calculated and compared among the different conditions. Both MI and BD significantly altered the slopes of the pressure-volume curves, whereas no effect was seen with atropine. Maximum distensibility was seen at the volume increment of 5-10 ml and was reduced with larger volumes. Distensibility measurements for the various test conditions tended to converge at the largest volume increment, suggesting that distensibility at this degree of distension was more related to the passive elastic properties of the GEJ. On the basis of these findings, we conclude that there can be significant active muscular contributions to recordings of distensibility at the GEJ, variations that must be controlled for during different study conditions.
Authors:
Reza Shaker; Eytan Bardan; Chengming Gu; Benson T Massey; Thomas Sanders; Mark K Kern; Raymond G Hoffmann; Walter J Hogan
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  287     ISSN:  0193-1857     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-13     Completed Date:  2004-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G815-21     Citation Subset:  IM    
Affiliation:
Medical College of Wisconsin Dysphagia Institute, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. rshaker@mcw.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atropine / administration & dosage
Balloon Dilatation
Diaphragm / physiology*
Esophagogastric Junction / physiology*
Female
Fluoroscopy
Humans
Inhalation
Male
Manometry
Middle Aged
Muscle Contraction / drug effects,  physiology*
Muscle Relaxation / physiology
Parasympatholytics / administration & dosage
Pressure
Chemical
Reg. No./Substance:
0/Parasympatholytics; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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