Document Detail


Lower esophageal sphincter relaxation is impaired in older patients with dysphagia.
MedLine Citation:
PMID:  21455332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To characterize the effects of age on the mechanisms underlying the common condition of esophageal dysphagia in older patients, using detailed manometric analysis.
METHODS: A retrospective case-control audit was performed on 19 patients aged ≥ 80 years (mean age 85 ± 0.7 year) who underwent a manometric study for dysphagia (2004-2009). Data were compared with 19 younger dysphagic patients (32 ± 1.7 years). Detailed manometric analysis performed prospectively included basal lower esophageal sphincter pressure (BLESP), pre-swallow and nadir LESP, esophageal body pressures and peristaltic duration, during water swallows (5 mL) in right lateral (RL) and upright (UR) postures and with solids. Data are mean ± SE; a P-value < 0.05 was considered significant.
RESULTS: Elderly dysphagic patients had higher BLESP than younger patients (23.4 ± 3.8 vs 14.9 ± 1.2 mmHg; P < 0.05). Pre-swallow LESP was elevated in the elderly in both postures (RL: 1 and 4 s P = 0.019 and P = 0.05; UR: P < 0.05 and P = 0.05) and solids (P < 0.01). In older patients, LES nadir pressure was higher with liquids (RL: 2.3 ± 0.6 mmHg vs 0.7 ± 0.6 mmHg, P < 0.05; UR: 3.5 ± 0.9 mmHg vs 1.6 ± 0.5 mmHg, P = 0.01) with shorter relaxation after solids (7.9 ± 1.5 s vs 9.7 ± 0.4 s, P = 0.05). No age-related differences were seen in esophageal body pressures or peristalsis duration.
CONCLUSION: Basal LES pressure is elevated and swallow-induced relaxation impaired in elderly dysphagic patients. Its contribution to dysphagia and the effects of healthy ageing require further investigation.
Authors:
Laura K Besanko; Carly M Burgstad; Reme Mountifield; Jane M Andrews; Richard Heddle; Helen Checklin; Robert J L Fraser
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  17     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-01     Completed Date:  2011-08-09     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1326-31     Citation Subset:  IM    
Affiliation:
Investigation and Procedures Unit, Repatriation General Hospital, South Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aging
Case-Control Studies
Deglutition Disorders / complications,  pathology*
Esophageal Achalasia / complications,  pathology*
Esophageal Sphincter, Lower / pathology*
Esophagus / pathology
Female
Humans
Male
Manometry / methods
Pressure
Retrospective Studies
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