The vagus plays a role in the anti-reflux barrier by controlling both the lower esophageal sphincter pressure and crural diaphragm activity

2005 ◽  
Vol 201 (3) ◽  
pp. S11 ◽  
Author(s):  
Patrick G. Jackson ◽  
Mark Niedringhaus ◽  
Joseph Verbalis ◽  
Stephen Evans ◽  
Gillis Richard ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Esophageal Sphincter ◽  
Crural Diaphragm ◽  
Diaphragm Activity

Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm activity, lower esophageal sphincter pressure, and fundus tone

2008 ◽  
Vol 294 (1) ◽  
pp. R121-R131 ◽  
Author(s):  
Mark Niedringhaus ◽  
Patrick G. Jackson ◽  
Stephen R. T. Evans ◽  
Joseph G. Verbalis ◽  
Richard A. Gillis ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Motor Nucleus ◽  
Sphincter Pressure ◽  
Vagus Nerves ◽  
Dorsal Motor Nucleus ◽  
Esophageal Sphincter ◽  
Crural Diaphragm ◽  
Stimulation Of

The sphincter mechanism at the esophagogastric junction includes smooth muscle of the lower esophagus and skeletal muscle of the crural diaphragm (CD). Smooth muscle is known to be under the control of the dorsal motor nucleus of the vagus (DMV), while central nervous system (CNS) control of the CD is unknown. The main purposes of our study were to determine the CNS site that controls the CD and whether simultaneous changes in lower esophageal sphincter (LES) pressure and CD activity occur when this site is activated. Experiments were performed on anesthetized male ferrets whose LES pressure, CD activity, and fundus tone were monitored. To activate DMV neurons, l-glutamate was microinjected unilaterally into the DMV at three areas: intermediate, rostral, and caudal. Stimulation of the intermediate DMV decreased CD activity (−4.8 ± 0.1 bursts/min and −0.3 ± 0.01 mV) and LES pressure (−13.2 ± 2.0 mmHg; n = 9). Stimulation of this brain site also produced an increase in fundus tone. Stimulation of the rostral DMV elicited increases in the activity of all three target organs ( n = 5). Stimulation of the caudal DMV had no effect on the CD but did decrease both LES pressure and fundus tone ( n = 5). All changes in LES pressure, fundus tone, and some DMV-induced changes in CD activity (i.e., bursts/min) were prevented by ipsilateral vagotomy. Our data indicate that simultaneous changes in activity of esophagogastric sphincters and fundus tone occur from rostral and intermediate areas of the DMV and that these changes are largely mediated by efferent vagus nerves.

Outcome of Pneumatic Balloon Dilatation in Achalasia Cardia

2021 ◽  
Vol 10 (1) ◽  
pp. 8-13
Author(s):  
Shankar Baral ◽  
Bidhan NIdhi Paudel ◽  
Ajit Khanal ◽  
Jiwan Thapa ◽  
Bhuwneshwer Yadhav ◽  
...  
Keyword(s):  
Observational Study ◽  
Lower Esophageal Sphincter ◽  
Poor Response ◽  
Lower Esophageal Sphincter Pressure ◽  
Pneumatic Dilatation ◽  
Response To Treatment ◽  
Sphincter Pressure ◽  
Achalasia Cardia ◽  
Type Iii ◽  
Esophageal Sphincter

Background: Achalasia Cardia is a rare esophageal motility disorder. Among various treatment options, Pneumatic Dilatation (PD) is the most widely used and cost effective modality till date. This is the first observational study aiming to evaluate the short term response and complications of PD for Achalasia Cardia in Nepal. Methods: This prospective observational study was conducted between 28th Jan 2020 to 27th Jan 2021. It included 39 patients with Achalasia Cardia diagnosed by clinical presentation, esophagoscopy, barium esophagogram and high resolution manometry. Two patients of Type III achalasia were excluded from study. Thirty seven patients underwent pneumatic dilatation with 30 mm Rigiflex balloon (Boston Scientific, USA) for a duration of 1 minute. Response was assessed by Eckardts score at 3 and 6 months. Result: Among 39 cases (mean age= 39.03±15.017 years, 59% men), commonest was Type II Achalasia (71.8%) followed by Type I (23.1%) and Type III (5.1%). Dysphagia was present in all patients (100%), followed by weight loss (84.6%), regurgitation (79.5%) and chest pain (35.9%). Mean basal Eckardts score and Lower Esophageal Sphincter pressure of the study population was 7.81±1.24 and 24.40±6.83 respectively. Response to pneumatic dilatation was 89.2%. Eckardts score changed significantly from7.81±1.24 to 1.03±1.82 at 6 months (p<0.001). None of the patients had major complications. Younger age (23±6.377 years) had poor response to treatment, while predilatation Lower Esophageal Sphincter pressure, gender and type of achalasia did not affect the treatment outcome. Conclusion: PD is safe and effective treatment modality for Achalasia. Younger patients have poor response to treatment with Pneumatic Dilatation.  

scholarly journals Effect of intraduodenal peptone on the lower esophageal sphincter pressure in the dog

1978 ◽  
Vol 75 (2) ◽  
pp. 283-285 ◽  
Author(s):  
H.R. Koelz ◽  
G. Lepsien ◽  
A.P. Hollinger ◽  
H. Säuberli ◽  
F. Largiadér ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Esophageal Sphincter

Esophageal manometry in the opossum.

1977 ◽  
Vol 233 (3) ◽  
pp. E152
Author(s):  
K Schulze ◽  
W J Dodds ◽  
J Christensen ◽  
J D Wood
Keyword(s):  
Animal Model ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Lower Esophageal Sphincter Pressure ◽  
Upper Esophageal Sphincter ◽  
Sphincter Pressure ◽  
Coronal Section ◽  
Esophageal Sphincter ◽  
Human Esophagus

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.

Effects of sodium nitroprusside and verapamil on lower esophageal sphincter

1980 ◽  
Vol 238 (1) ◽  
pp. G40-G44
Author(s):  
R. K. Goyal ◽  
S. Rattan
Keyword(s):  
Blood Pressure ◽  
Sodium Nitroprusside ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Sphincter Pressure ◽  
Calcium Activation ◽  
Arterial Blood ◽  
In Series ◽  
Esophageal Sphincter ◽  
Dose Dependent

Infusions of verapamil (V) and sodium nitroprusside (NP) caused dose-dependent reductions in the lower esophageal sphincter pressure (LESP) in anesthetized opossums. Verapamil caused a gradual fall during the infusion and a gradual recovery upon cessation of the infusion. On the other hand, NP caused a prompt reduction and a prompt recovery. Both the agents also caused a fall in arterial blood pressure, but the fall in LESP was not related to the fall in the blood pressure. Both the agents antagonized the tonic and the phasic components of the LESP and, in large doses, both drugs almost abolished the LESP. Esophageal contractions were also antagonized by both agents, although verapamil was more effective than nitroprusside in this regard. These studies show that phasic and tonic components of LESP are not related to distinctive verapamil and nitroprusside sensitive calcium activation systems. Moreover, the V- and NP-sensitive calcium activation systems may lie in series rather than parallel.

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