Responses of the upper esophageal sphincter and esophageal body to graded intraluminal distension.
1. The responses of the upper esophageal sphincter (UES) to graded intraluminal distension of the esophagus were examined to determine response thresholds and to define the functional relationship between the sphincter and the esophageal body. 2. Nine normal subjects underwent manometric examination using a multiluminal tube with an attached inflatable balloon located 10 cm below the UES. Sphincter and esophageal motor responses to six balloon inflation volumes (1, 2, 4, 6, 8, and 10 ml) were recorded in each subject. 3. The UES responded to distension by increasing pressure, from a median value of 42.5 mmHg with a threshold distension of 1.0 cm, to 95 mmHg at 2.2 cm. Non-swallow-related, secondary contractile waves were stimulated in the esophageal body proximal to the distension and increased in number as inflation increased. Distal propagation of this secondary activity was inhibited with increasing distension. The amplitude of the primary peristalsis increased significantly to 61.7 mmHg at 2.2 cm. 4. These data demonstrate the normal upper esophageal motor responses to distension and provide a reference for future investigations of patients showing evidence of impaired esophageal clearance and in whom standard manometry may be unhelpful.
Department of Gastroenterology, London Hospital, England.
N A
NA
Andreollo
D G
DG
Thompson
G P
GP
Kendall
R J
RJ
Earlam
D000328:Adult; D002404:Catheterization; D004947:Esophagus / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D011312:Pressure