Document Detail

Laryngo-upper esophageal sphincter contractile reflex in humans deteriorates with age.
MedLine Citation:
PMID:  15236172     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Recent studies have shown the existence of several reflex connections between the aerodigestive and upper gastrointestinal tracts. Our aim was to study the effect of laryngeal stimulation on upper esophageal sphincter (UES) pressure and to determine the reproducibility of this effect. METHODS: We studied 14 young and 10 elderly healthy nonsmoker volunteers and 7 patients with UES dysphagia using a concurrent manometric and video endoscopic technique. Three levels of laryngeal air stimulation were studied: 6 mm Hg/50 ms, 10 mm Hg/50 ms, and 6 mm Hg/2 s. Ten young subjects were studied twice. RESULTS: For 6-mm Hg/2-s and 6-mm Hg/50-ms duration stimuli, the frequency of UES response to air stimulation as evidenced by mucosal deflection (response/deflection ratio) in the elderly volunteers was significantly lower compared with that of young subjects (P < 0.05). The response/deflection ratio of the 6-mm Hg/2-s stimulus was significantly higher than those induced by stimuli of shorter duration (P < 0.01). Poststimulation UES pressure was significantly higher than prestimulation pressure (P < 0.05) in both groups. The magnitude of the increase in poststimulation UES pressure in the elderly volunteers was similar to that of the young subjects. Findings were similar in repeated studies. Four of 7 dysphagic patients exhibited an abnormal response. CONCLUSIONS: Afferent signals originating from the larynx reproducibly induce contraction of the UES: the laryngo-UES contractile reflex. This reflex is elicited most reliably by 6-mm Hg/2-s air stimulation. Frequency elicitation of this reflex decreases significantly with age while the magnitude of change in UES pressure remains unchanged, indicating a deleterious effect of aging on the afferent arm of this reflex. This reflex is altered in some dysphagic patients.
Osamu Kawamura; Caryn Easterling; Muhammad Aslam; Tanya Rittmann; Candy Hofmann; Reza Shaker
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Gastroenterology     Volume:  127     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-05     Completed Date:  2004-09-28     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-64     Citation Subset:  AIM; IM    
Medical College of Wisconsin Dysphagia Institute, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Aging / physiology
Deglutition Disorders / physiopathology
Digestive System Physiological Phenomena
Esophagogastric Junction / physiology,  physiopathology*
Larynx / physiology,  physiopathology*
Muscle Contraction / physiology
Reflex / physiology
Reflex, Abnormal / physiology*
Reproducibility of Results
Respiratory Physiological Phenomena
Grant Support

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

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