| Upper esophageal sphincter during transient lower esophageal sphincter relaxation: effects of reflux content and posture. | |
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MedLine Citation:
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PMID: 20167874 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although some studies show that the upper esophageal sphincter (UES) contracts during transient lower esophageal sphincter relaxation (TLESR), others show that it relaxes. We hypothesized that the posture of the subject and constituents of gastroesophageal reflux (GER) may determine the type of UES response during the TLESR. High-resolution manometry and esophageal pH/impedance recording were performed in 10 healthy volunteers in the right recumbent (1 h) and upright (1 h) positions following the ingestion of a 1,000-Kcal meal. The UES pressure response during TLESR and constituents of GER (liquid, air, and pH) were determined. 109 TLESRs (58 upright and 51 recumbent) were analyzed. The majority of TLESRs were associated with GER (91% upright and 88% recumbent) events. UES relaxation was the predominant response during upright position (81% of TLESRs), and it was characteristically associated with presence of air in the reflux (92%). On the other hand, UES contraction was the predominant response during recumbent position (82% of TLESRs), and it was mainly associated with liquid reflux (71%). The rate of esophageal pressure increase (dP/dt) during the GER, but not the pH, had major influence on the type of UES response during TLESR. The dP/dt during air reflux (127 +/- 39 mmHg/s) was significantly higher than liquid reflux (31 +/- 6 mmHg/s, P < 0.0001). We concluded that the nature of UES response during TLESR, relaxation or contraction, is related to the posture and the constituents of GER. We propose that the rapid rate of esophageal pressure increase associated with air reflux determines the UES relaxation response to GER. |
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Authors:
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Arash Babaei; Valmik Bhargava; Ravinder K Mittal |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-02-18 |
Journal Detail:
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Title: American journal of physiology. Gastrointestinal and liver physiology Volume: 298 ISSN: 1522-1547 ISO Abbreviation: Am. J. Physiol. Gastrointest. Liver Physiol. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-20 Completed Date: 2010-05-06 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 100901227 Medline TA: Am J Physiol Gastrointest Liver Physiol Country: United States |
Other Details:
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Languages: eng Pagination: G601-7 Citation Subset: IM |
Affiliation:
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University of California, San Diego, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Electric Impedance Esophageal Sphincter, Lower / physiology* Esophageal Sphincter, Upper / physiology* Female Gastroesophageal Reflux / physiopathology* Humans Hydrogen-Ion Concentration Male Manometry Middle Aged Muscle Contraction Muscle Relaxation Posture* |
| Grant Support | |
ID/Acronym/Agency:
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R01-DK060733/DK/NIDDK NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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