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Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation

Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES... Abstract Lower esophageal sphincter (LES) relaxation and esophageal body inhibition co-occur during esophageal peristalsis but not necessarily during pharyngeal stimulation or transient LES relaxation (tLESR). This study examined these relationships and the impact on reflux. Nine young volunteers were studied. An artificial high-pressure zone (HPZ) was established, and pH was recorded 8 and 5 cm proximal to the LES. Pharyngeal stimulation was by water injection and gastric distension with liquid or gas. Peristalsis, pharyngeal stimulation, and spontaneous events were recorded. Swallowing relaxed the LES in 100% of trials (the HPZ in 80%) and caused no reflux. Pharyngeal stimulation relaxed the LES in two-thirds of trials, had no effect on the HPZ, and caused no reflux. Gastric distension was associated with 117 tLESRs, 48% with acid reflux, and 32% with gas reflux; there was no effect on the HPZ. We conclude that LES relaxation is a necessary but not sufficient condition for reflux. LES relaxation and esophageal body inhibition are independent events that may be concurrent (swallowing) or dissociated (tLESR). esophageal primary peristalsis transient LES relaxation gastroesophageal reflux pharynx swallow Footnotes Address for reprint requests and other correspondence: P. Pouderoux, Service d'Hépato-Gastroentérologie et Alcoologie, Centre Hospitalier et Universitaire de Nı̂mes, Hôpital Caremeau, Ave. du Professeur Robert Debré, 30900 Nı̂mes, France (E-mail: philippe.pouderoux@chu-nimes.fr ). The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “ advertisement ” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. First published October 15, 2002;10.1152/ajpgi.00301.2002 Copyright © 2003 the American Physiological Society http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png AJP - Gastrointestinal and Liver Physiology The American Physiological Society

Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation

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References (21)

Publisher
The American Physiological Society
Copyright
Copyright © 2011 the American Physiological Society
ISSN
0193-1857
eISSN
1522-1547
DOI
10.1152/ajpgi.00301.2002
pmid
12388187
Publisher site
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Abstract

Abstract Lower esophageal sphincter (LES) relaxation and esophageal body inhibition co-occur during esophageal peristalsis but not necessarily during pharyngeal stimulation or transient LES relaxation (tLESR). This study examined these relationships and the impact on reflux. Nine young volunteers were studied. An artificial high-pressure zone (HPZ) was established, and pH was recorded 8 and 5 cm proximal to the LES. Pharyngeal stimulation was by water injection and gastric distension with liquid or gas. Peristalsis, pharyngeal stimulation, and spontaneous events were recorded. Swallowing relaxed the LES in 100% of trials (the HPZ in 80%) and caused no reflux. Pharyngeal stimulation relaxed the LES in two-thirds of trials, had no effect on the HPZ, and caused no reflux. Gastric distension was associated with 117 tLESRs, 48% with acid reflux, and 32% with gas reflux; there was no effect on the HPZ. We conclude that LES relaxation is a necessary but not sufficient condition for reflux. LES relaxation and esophageal body inhibition are independent events that may be concurrent (swallowing) or dissociated (tLESR). esophageal primary peristalsis transient LES relaxation gastroesophageal reflux pharynx swallow Footnotes Address for reprint requests and other correspondence: P. Pouderoux, Service d'Hépato-Gastroentérologie et Alcoologie, Centre Hospitalier et Universitaire de Nı̂mes, Hôpital Caremeau, Ave. du Professeur Robert Debré, 30900 Nı̂mes, France (E-mail: philippe.pouderoux@chu-nimes.fr ). The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “ advertisement ” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. First published October 15, 2002;10.1152/ajpgi.00301.2002 Copyright © 2003 the American Physiological Society

Journal

AJP - Gastrointestinal and Liver Physiology – The American Physiological Society

Published: Feb 1, 2003

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