title: Digestive and respiratory tract motor responses associated with eructation.
abstract: We studied the digestive and respiratory tract motor responses in 10 chronically instrumented dogs during eructation activated after feeding. Muscles were recorded from the cervical area, thorax, and abdomen. The striated muscles were recorded using EMG and the smooth muscles using strain gauges. We found eructation in three distinct functional phases that were composed of different sets of motor responses: gas escape, barrier elimination, and gas transport. The gas escape phase, activated by gastric distension, consists of relaxation of the lower esophageal sphincter and diaphragmatic hiatus and contraction of the longitudinal muscle of the thoracic esophagus and rectus abdominis. All these motor events promote gas escape from the stomach. The barrier elimination phase, probably activated by rapid gas distension of the thoracic esophagus, consists of relaxation of the pharyngeal constrictors and excitation of dorsal and ventral upper esophageal sphincter distracting muscles, as well as rapid contraction of the diaphragmatic dome fibers. These motor events allow esophagopharyngeal air movement by promoting retrograde airflow and opening of the upper esophageal sphincter. The transport phase, possibly activated secondary to diaphragmatic contraction, consists of a retrograde contraction of the striated muscle esophagus that transports the air from the thoracic esophagus to the pharynx. We hypothesize that the esophageal reverse peristalsis is mediated by elementary reflexes, rather than a coordinated peristaltic response like secondary peristalsis. The phases of eructation can be activated independently of one another or in a different manner to participate in physiological events other than eructation that cause gastroesophageal or esophagogastric reflux.
authors.affiliation: Dysphagia Animal Institute, Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. imlang@mcw.edu
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Lang
authors.forename: Bidyut K
authors.initials: BK
authors.lastname: Medda
authors.forename: Reza
authors.initials: R
authors.lastname: Shaker
mesh_terms: D000818:Animals; D003964:Diaphragm / Q000503:physiopathology; D004285:Dogs; D004576:Electromyography; D004884:Eructation / Q000503:physiopathology*; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D007830:Larynx / Q000503:physiopathology*; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology; D010528:Peristalsis; D010614:Pharynx / Q000503:physiopathology*; D017568:Rectus Abdominis / Q000503:physiopathology; D013270:Stomach / Q000503:physiopathology
keywords: belching; esophagus; gastrointestinal motor activity; larynx; pharynx