Relationship between bolus transit and LES-relaxation studied with concurrent impedance and manometry.
OBJECTIVE
Neuromuscular mechanisms regulating esophageal bolus transport are well studied. However, detailed data about the relationship between bolus transit and lower esophageal sphincter (LES)-relaxation during conventional motility testing are still lacking.


METHODS
We performed systematic studies in 25 normal subjects, employing a catheter that integrates the two techniques impedancometry and manometry in a single instrument for simultaneous recording and analysis of the relationship between bolus transit and LES relaxation after swallowing saline or yogurt.


RESULTS
195 swallows were analyzed. LES relaxation occurred frequently later than UES relaxation. The mean latency between bolus entry into the esophagus and LES relaxation was 3.6 +0.2 sec. Two types of swallow-induced LES relaxation were observed: (a) LES relaxation preceding bolus transit (46 cases or 24%) and (b) LES relaxation occurring during bolus transit (149 cases or 76%). In the later case, during 114 (76%) cases of this deglutition, the position of the bolus was very close to the LES.


CONCLUSIONS
During deglutition, LES relaxation seems to be modulated by bolus transit and occurs predominantly upon arrival of the bolus in the distal esophagus.
Nguyen
H N
HN
Department of Medicine, Division of Gastroenterology and Helmholtz Institute of Biomedical Engineering University of Technology RWTH-Aachen, Germany. huan.nguyen@SK-MG.de
Domingues
G R
GR
Winograd
R
R
Lammert
F
F
Silny
J
J
Matern
S
S
D000328:Adult; D003679:Deglutition / Q000502:physiology*; D017097:Electric Impedance; D004867:Equipment Design; D049630:Esophageal Sphincter, Lower / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation*; D009126:Muscle Relaxation / Q000502:physiology*; D010528:Peristalsis / Q000502:physiology; D012016:Reference Values