| The impact of continuous positive airway pressure on the lower esophageal sphincter. | |
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MedLine Citation:
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PMID: 17234890 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The lower esophageal sphincter (LES) is the primary barrier to gastroesophageal reflux. Reflux is associated with periods of LES relaxation, as occurs during swallowing. Continuous positive airway pressure (CPAP) has been shown to reduce reflux in individuals with and without sleep apnea, by an unknown mechanism. The aim of this study was to determine the effect of CPAP on swallow-induced LES relaxation. Measurements were made in 10 healthy, awake, supine individuals. Esophageal (Pes), LES (Ples), gastric (Pg), and barrier pressure to reflux (Pb = Ples - Pg) were recorded using a sleeve catheter during five swallows of 5 ml of water. This was repeated at four levels of CPAP (0, 5, 10, and 15 cmH(2)O). Pressures were measured during quiet breathing and during the LES relaxation associated with a swallow. Duration of LES relaxation was also recorded. During quiet breathing, CPAP significantly increased end-expiratory Pes, Ples, Pg, and Pb (P < 0.05). The increase in Pb was due to a disproportionate increase in Ples compared with Pg (P < 0.05). During a swallow, CPAP increased nadir Ples, Pg, and Pb and decreased the duration of LES relaxation (4.1 s with 0-cmH(2)O CPAP to 1.6 s on 15-cmH(2)O CPAP, P < 0.001). Pb increased with CPAP by virtue of a disproportionate increase in Ples compared with Pg. This may be due to either reflex activation of LES smooth muscle, or nonspecific transmission of pressure to the LES. The findings suggest CPAP may make the LES less susceptible to reflux by increasing Pb and decreasing the duration of LES relaxation. |
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Authors:
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Kelly L Shepherd; Richard H Holloway; David R Hillman; Peter R Eastwood |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-01-18 |
Journal Detail:
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Title: American journal of physiology. Gastrointestinal and liver physiology Volume: 292 ISSN: 0193-1857 ISO Abbreviation: Am. J. Physiol. Gastrointest. Liver Physiol. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-05-10 Completed Date: 2007-07-06 Revised Date: - |
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: G1200-5 Citation Subset: IM |
Affiliation:
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West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Continuous Positive Airway Pressure* Esophageal Sphincter, Lower / physiology* Female Gastroesophageal Reflux / prevention & control Humans Male Pressure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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