title: The effect of an effortful swallow on the normal adult esophagus.
abstract: The effect of an effortful swallow on the healthy adult esophagus was investigated using concurrent oral and esophageal manometry (water perfusion system) on ten normal adults (5 males and 5 females, 20-35 years old) while swallowing 5-ml boluses of water. The effects of gender, swallow condition (effortful versus noneffortful swallows), and sensor site within the oral cavity, esophageal body, and lower esophageal sphincter (LES) were examined relative to amplitude, duration, and velocity of esophageal body contractions, LES residual pressure, and LES relaxation duration. The results of this study provide novel evidence that an effortful oropharyngeal swallow has an effect on the esophageal phase of swallowing. Specifically, effortful swallowing resulted in significantly increased peristaltic amplitudes within the distal smooth muscle region of the esophagus, without affecting the more proximal regions containing striated muscle fibers. The findings pertaining to the LES are inconclusive and require further exploration using methods that permit more reliable measurements of LES function. The results of this study hold tremendous clinical potential for esophageal disorders that result in abnormally low peristaltic pressures in the distal esophageal body, such as achalasia, scleroderma, and ineffective esophageal motility. However, additional studies are necessary to both replicate and extend the present findings, preferably using a solid-state manometric system in conjunction with bolus flow testing on both normal and disordered populations, to fully characterize the effects of an effortful swallow on the esophagus.
authors: Department of Communication Sciences and Disorders, School of Allied Health Sciences, East Carolina University, Greenville, North Carolina 27858, USA. tel0324@mail.ecu.edu
authors: Teresa E
authors: TE
authors: Lever
authors: Kathleen T
authors: KT
authors: Cox
authors: Donald
authors: D
authors: Holbert
authors: Mamun
authors: M
authors: Shahrier
authors: Monica
authors: M
authors: Hough
authors: Kristine
authors: K
authors: Kelley-Salamon
mesh_terms: D000328:Adult; D003679:Deglutition; D003680:Deglutition Disorders / Q000503:physiopathology*; D004931:Esophageal Achalasia; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D004947:Esophagus / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation; D011446:Prospective Studies; D011795:Surveys and Questionnaires
references: Neurogastroenterol Motil. 2005 Jun;17 Suppl 1:3-12
references: 15836450
references: J Physiol. 2003 Aug 15;551(Pt 1):287-94
references: 12813149
references: Adv Physiol Educ. 2003 Dec;27(1-4):201-6
references: 14627618
references: Braz J Med Biol Res. 1998 Apr;31(4):539-44
references: 9698807
references: Dig Dis Sci. 2000 Feb;45(2):285-8
references: 10711439
references: Z Zellforsch Mikrosk Anat. 1968;91(2):236-47
references: 4894063
references: Braz J Med Biol Res. 2002 Jun;35(6):677-83
references: 12045832
references: Am J Physiol. 1998 Feb;274(2 Pt 1):G325-30
references: 9486186
references: Arch Phys Med Rehabil. 2001 Dec;82(12):1661-5
references: 11733879
references: Gastroenterology. 1994 Dec;107(6):1865-84
references: 7958705
references: Dig Dis Sci. 1997 Sep;42(9):1859-65
references: 9331148
references: Dysphagia. 2001 Summer;16(3):190-5
references: 11453566
references: Ann Intern Med. 1984 Jun;100(6):848-50
references: 6609658
references: J Anat. 1972 Jul;112(Pt 2):173-84
references: 5077190
references: J Anat. 1987 Aug;153:233-9
references: 3429323
references: Histochem Cell Biol. 2005 Feb;123(2):117-30
references: 15729553
references: J Clin Gastroenterol. 2001 Jul;33(1):27-31
references: 11418786
references: Psychosom Med. 1978 Dec;40(8):610-9
references: 154683
references: Ann Intern Med. 1963 Sep;59:351-6
references: 14065952
references: Laryngoscope. 1999 Mar;109(3):437-41
references: 10089972
references: Science. 1969 Jan 31;163(3866):434-45
references: 5812527
references: J Auton Nerv Syst. 1998 May 28;70(1-2):92-102
references: 9686909
references: Gut. 1994 Dec;35(12):1690-6
references: 7530228
references: Cell Tissue Res. 1999 Feb;295(2):241-5
references: 9931370
references: Am J Physiol. 1991 Oct;261(4 Pt 1):G677-84
references: 1928353
references: Dysphagia. 2002 Summer;17(3):197-201
references: 12140645
references: Cell Tissue Res. 1994 Apr;276(1):23-30
references: 8187163
references: Am J Physiol Gastrointest Liver Physiol. 2000 Aug;279(2):G255-61
references: 10915632
references: Am J Physiol Gastrointest Liver Physiol. 2005 Jun;288(6):G1190-4
references: 15650131
references: Sci Am. 1970 Jan;222(1):30-9
references: 5410259
references: Am J Gastroenterol. 1987 Aug;82(8):754-7
references: 3605034
references: Am J Gastroenterol. 1998 Dec;93(12):2373-9
references: 9860395
references: Invest Radiol. 1982 Nov-Dec;17(6):567-72
references: 7152861
references: Gastroenterology. 1988 Jan;94(1):73-80
references: 3335301
references: Folia Phoniatr Logop. 2002 Jul-Aug;54(4):171-6
references: 12169803
references: Dig Dis Sci. 2003 Jun;48(6):1057-61
references: 12822862
references: Dig Dis Sci. 1987 Jun;32(6):583-92
references: 3568945
references: Gastrointest Endosc Clin N Am. 2001 Apr;11(2):281-92, vi
references: 11319062
references: Anat Rec. 2001 Jan 1;262(1):41-6
references: 11146427
references: Gastroenterology. 1993 Nov;105(5):1411-20
references: 7901108
references: Chest Surg Clin N Am. 1995 Feb;5(1):157-71
references: 7743145
references: Neurogastroenterol Motil. 2003 Feb;15(1):57-62
references: 12588469
references: J Forensic Sci. 1994 Mar;39(2):547-51
references: 8195764
references: J Clin Gastroenterol. 2000 Apr;30(3):270-3
references: 10777186
references: Am J Gastroenterol. 1999 Jul;94(7):1795-801
references: 10406237
references: Obes Surg. 1999 Aug;9(4):390-5
references: 10484299
references: Okajimas Folia Anat Jpn. 2002 Mar;78(6):263-79
references: 12126058
references: Gastroenterology. 1987 Mar;92(3):643-50
references: 3817387
references: Dysphagia. 1999 Spring;14(2):67-72
references: 10028035
references: Am J Gastroenterol. 1991 May;86(5):609-14
references: 2028954
references: Gastroenterology. 1996 Feb;110(2):419-23
references: 8566588
references: J Clin Gastroenterol. 1986 Apr;8(2):131-4
references: 3745845
references: Am J Physiol. 1988 Dec;255(6 Pt 1):G794-9
references: 3202172