Pharyngeal swallowing mechanics associated with upper esophageal sphincter pressure wave

The opossum esophagus is commonly used as an animal model of the human esophagus. We used esophageal manometry in normal animals to provide basal data about normal esophageal motor functions in vivo in this species. At rest, separate and distinct high pressure zones can be recorded at the level of the lower esophageal sphincter, diaphragmatic hiatus, aortic arch, and upper esophageal sphincter. Each zone demonstrates a characteristic pattern of pressures in the radii of the coronal section and a characteristic response to swallowing. The hiatal and aortic zones can be mistaken for the esophageal sphincters. Pressures in the sphincters fall with swallowing. Peristalsis is not bolus-dependent and occurs with 98% of swallows. Pressures generated by peristalsis are greater in the middle of the esophagus than at the ends. Values for resting lower esophageal sphincter pressure and the characteristics of peristalsis were reproducible between different studies in the same animals.

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Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1993.264.3.g427 ◽

1993 ◽

Vol 264 (3) ◽

pp. G427-G432 ◽

Cited By ~ 25

Author(s):

R. Shaker ◽

J. Ren ◽

B. Podvrsan ◽

W. J. Dodds ◽

W. J. Hogan ◽

...

Keyword(s):

Pressure Wave ◽

Wave Amplitude ◽

Age Groups ◽

The Elderly ◽

Young Group ◽

Upper Esophageal Sphincter ◽

Healthy Elderly ◽

Pressure Wave Amplitude ◽

Resting Pressure ◽

Esophageal Sphincter

Effect of aging, bolus volume, temperature, and consistency on the pharyngeal peristalsis, as well as the effect of aging on the upper esophageal sphincter (UES) resting pressure and its response to esophageal distension by air and balloon, were studied in 14 young and 12 healthy elderly volunteers. In both age groups there was no significant volume or temperature effect on amplitude, duration, or velocity of the pharyngeal peristalsis. Compared with water swallows, mashed potato swallows resulted in a significant increase in the amplitude and duration of the hypopharyngeal peristaltic pressure wave (P < 0.05). For water swallows, the amplitude and duration of the peristaltic pressure wave in the hypopharynx were significantly increased in the elderly compared with the young group (P < 0.01). UES resting pressure in the elderly measured 43 +/- 5 (SE) mmHg and was significantly less than that of the young (71 +/- 8 mmHg; P < 0.01). Magnitude of the UES pressure decrease because of esophageal distension by air, as well as magnitude of its pressure increase because of esophageal balloon distension, was similar among young and elderly. 1) Contrary to common expectations, the parameters of the pharyngeal peristaltic pressure wave do not deteriorate in the elderly in their seventh and eighth decade. 2) Compared with the young, hypopharyngeal pressure wave amplitude and duration are significantly increased in the elderly. This increase could be caused by an adaptation response to a pharyngeal outflow compromise. 3) Pharyngeal peristaltic pressure wave amplitude and duration, but not its velocity, are modulated by the bolus consistency. This modulatory mechanism is preserved in the elderly. 4) Although UES resting pressure is significantly decreased in the elderly, its pressure response to esophageal distension by air and balloon is preserved.

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Tu1164 Upper Esophageal Sphincter Pressure Does Not Correlate With Anxiety, Depression or Somatization

Gastroenterology ◽

10.1016/s0016-5085(15)32752-9 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-808

Author(s):

Shreya Raja ◽

Sonali Palchaudhuri ◽

Ellen M. Stein ◽

Monica Nandwani ◽

Kristle Lynch ◽

...

Keyword(s):

Upper Esophageal Sphincter ◽

Sphincter Pressure ◽

Esophageal Sphincter ◽

Anxiety Depression

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378 Resting Upper Esophageal Sphincter Pressure Is Elevated in Proton Pump Inhibitor-Refractory Chronic Cough Patients and May Be a Marker for Laryngeal Hypersensitivity

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000591044.05103.2f ◽

2019 ◽

Vol 114 (1) ◽

pp. S221-S221

Author(s):

John Bloch ◽

Salih Samo ◽

Anand Jain

Keyword(s):

Proton Pump Inhibitor ◽

Proton Pump ◽

Chronic Cough ◽

Upper Esophageal Sphincter ◽

Sphincter Pressure ◽

Esophageal Sphincter

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W1887 Hyperdynamic Upper Esophageal Sphincter Pressure: A Manometric Marker of Globus Sensation

Gastroenterology ◽

10.1016/s0016-5085(08)63392-2 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-726

Author(s):

Faiz Mirza ◽

John E. Pandolfino ◽

Peter J. Kahrilas ◽

Monika A. Kwiatek

Keyword(s):

Upper Esophageal Sphincter ◽

Sphincter Pressure ◽

Globus Sensation ◽

Esophageal Sphincter

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S118 – Study of Pharyngeal Swallowing by High-resolution Manometry

Otolaryngology ◽

10.1016/j.otohns.2008.05.291 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P116-P117

Author(s):

Kenji Takasaki ◽

Umeki Hiroshi ◽

Kaori Enatsu ◽

Fujinobu Tanaka ◽

Hidetaka Kumagami ◽

...

Keyword(s):

High Resolution ◽

Normal Values ◽

Upper Esophageal Sphincter ◽

Cervical Esophagus ◽

High Resolution Manometry ◽

Maximum Value ◽

Physiological Information ◽

Asymptomatic Adult ◽

Esophageal Sphincter ◽

Pharyngeal Swallowing

Objectives This study aimed to demonstrate the feasibility of a novel high-resolution manometry (HRM) system, and to establish normal values of swallowing pressures along the velopharynx and upper esophagus. Methods 33 asymptomatic adult Japanese controls were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the swallowing (dry and 5 ml of water) pressures at velo, meso-hypopharynx, and at the upper esophageal sphincter (UES) were measured. The resting UES pressure, the length of the part in the cervical esophagus showing the resting UES pressure, and the distance from the nostril to the above-mentioned points of pressure were also measured. Results The maximum value of dry and water swallowing pressures at the velopharynx, meso-hypopharynx and UES, and the distances from the nasal vestibulum to each point were 132.3±61.3 (mmHg, mean ± standard deviation), and 146.5±77.5, 171.6±52.0, and 176.3±74.4, 163.5±70.6, and 239.3±80.1, and 9.8±1.2 (cm), and 9.8±1.3, 13.6±1.6, and 13.7±1.5, 17.0±1.9 and 17.1±1.6, respectively. The maximum value of the resting USE pressure, the length of the part in the cervical esophagus showing the resting USE pressure, and the distance from the nostril to the mid-point of the length of the resting UES pressure were 66.6±28.1 mmHg, 3.8±0.7 cm, and 18.2±1.6 cm, respectively. Conclusions The present study provides anatomical and physiological information about normal swallowing along the velopharynx and upper esophagus, which will be an aid to future clinical and investigative studies.

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Effects of Head Rotation on Pharyngeal Function during Normal Swallow

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949810700414 ◽

1998 ◽

Vol 107 (4) ◽

pp. 344-348 ◽

Cited By ~ 55

Author(s):

Yukio Ohmae ◽

Masami Ogura ◽

Satoshi Kitahara ◽

Takehiro Karaho ◽

Tetsuzo Inouye

Keyword(s):

Healthy Subjects ◽

Head Rotation ◽

Normal Subjects ◽

Upper Esophageal Sphincter ◽

Resting Pressure ◽

Esophageal Sphincter ◽

Pharyngeal Clearance ◽

Pharyngeal Swallowing ◽

Peak Pressures ◽

Pharyngeal Function

This study quantified the effects of head rotation on pharyngeal swallowing in healthy subjects. Videofluoroscopic and oropharyngeal manometric examinations of pharyngeal swallowing were performed on seven volunteers with the head in neutral and rotated positions. Videofluoroscopic study revealed that head rotation swallow causes the bolus to lateralize away from the direction of head rotation. Pharyngeal manometric study indicated that the pharyngeal peak pressures toward the side of head rotation were significantly increased, whereas the pharyngeal pressures opposite the side of head rotation were not affected. Head rotation swallow produced a significant fall in upper esophageal sphincter (UES) resting pressure and a delay in UES closing. We concluded that the head rotation swallow in normal subjects not only alters the bolus pathway, but also has a useful effect on both pharyngeal clearance and UES dynamics.

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