title: Changes in esophageal and lower esophageal sphincter motility with healthy aging.
abstract: OBJECTIVE
  Swallowing difficulties become increasingly prevalent in older age. Differences exist in lower esophageal sphincter (LES) function between older and younger patients with dysphagia, but the contribution of aging per se to these is unclear.
  
  
  METHODS
  Esophageal motor function was measured using high resolution manometry in older (aged 81+/-1.7 yrs) and younger (23+/-1.7 yrs) asymptomatic healthy adults. After baseline recording, motility was assessed by swallowing boluses of liquid (right lateral and upright postures) and solids. Basal LES pressure, integrated relaxation pressure, distal esophageal peristaltic amplitude, distal contractile integral and velocity were measured. Data are presented as mean +/- SEM.
  
  
  RESULTS
  Despite a trend for lower basal LES pressure (15.8+/-2.9 mmHg vs. 21.0+/-0.2 mmHg; P=0.08), completeness of LES relaxation was reduced in older subjects (liquid RL: P=0.003; UR: P=0.007; solid: P=0.03), with higher integrated relaxation pressure when upright (liquid: 6.9+/-1.1 vs. 3.1+/-0.4 mmHg; P=0.01; solids: 8.1+/-1.1 vs. 3.6+/-0.3 mmHg; P=0.001) and a longer time to recovery after liquid boluses (right lateral: P=0.01; upright: P=0.04). In young, but not older adults, esophageal peristaltic velocity was increased when upright (3.6+/-0.2 cm/sec; P=0.04) and reduced with solids (3.0+/-0.1 cm-s; P=0.03). Distal contraction amplitude was higher with solid cf. liquid in the younger individuals (51.8+/-7.9 mmHg vs. 41.4+/-6.2 mmHg; P=0.03). In elderly subjects, the distal contractile integral was higher with liquid swallows in the upright posture (P=0.006).
  
  
  CONCLUSIONS
  There are subtle changes in LES function even in asymptomatic older individuals. These age-related changes may contribute to the development of dysphagia.
authors.affiliation: Investigation and Procedures Unit, Repatriation General Hospital,Australia. laura.besanko@health.sa.gov.au.
authors.forename: Laura K
authors.initials: LK
authors.lastname: Besanko
authors.affiliation: Investigation and Procedures Unit, Repatriation General Hospital,Australia.
authors.forename: Carly M
authors.initials: CM
authors.lastname: Burgstad
authors.affiliation: Investigation and Procedures Unit, Repatriation General Hospital; School of Medicine, Flinders University of South Australia, Australia.
authors.forename: Charles
authors.initials: C
authors.lastname: Cock
authors.affiliation: Investigation and Procedures Unit, Repatriation General Hospital,Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Heddle
authors.affiliation: Investigation and Procedures Unit, Repatriation General Hospital,Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Fraser
authors.affiliation: School of Medicine, Flinders University of South Australia, Australia.
authors.forename: Robert J L
authors.initials: RJ
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D010528:Peristalsis; D011187:Posture; D011312:Pressure; D012307:Risk Factors; D055815:Young Adult