title: The Physiology of Eructation.
abstract: Eructation is composed of three independent phases: gas escape, upper barrier elimination, and gas transport phases. The gas escape phase is the gastro-LES inhibitory reflex that causes transient relaxation of the lower esophageal sphincter, which is activated by distension of stretch receptors of the proximal stomach. The upper barrier elimination phase is the transient relaxation of the upper esophageal sphincter along with airway protection. This phase is activated by stimulation of rapidly adapting mechanoreceptors of the esophageal mucosa. The gas transport phase is esophageal reverse peristalsis mediated by elementary reflexes, and it is theorized that this phase is activated by serosal rapidly adapting tension receptors. Alteration of the receptors which activate the upper barrier elimination phase of eructation by gastro-esophageal reflux of acid may in part contribute to the development of supra-esophageal reflux disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. imlang@mcw.edu.|Dysphagia Institute Animal Research Laboratory, MACC Fund Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, 4066, Milwaukee, WI, 53226, USA. imlang@mcw.edu.
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Lang
mesh_terms: D004884:Eructation / Q000209:etiology / Q000503:physiopathology*; D000071041:Esophageal Mucosa / Q000502:physiology; D049630:Esophageal Sphincter, Lower / Q000502:physiology; D049631:Esophageal Sphincter, Upper / Q000502:physiology; D005740:Gases; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008465:Mechanoreceptors / Q000502:physiology; D010528:Peristalsis / Q000502:physiology*; D013270:Stomach / Q000502:physiology
chemical_list: D005740:Gases
keywords: Belching; Eructation; Esophageal reverse peristalsis; Esophago-pharyngeal reflux (EPR); Supra-esophageal reflux disease (SERD); Transient relaxation of the lower esophageal sphincter (TLESR); Transient relaxation of the upper esophageal sphincter (TUESR)