Influence of Sleep Stages on Esophago-Upper Esophageal Sphincter Contractile Reflex and Secondary Esophageal Peristalsis

Esophageal peristaltic pressure amplitude, peristaltic incidence, speed of peristalsis, and wave duration were investigated as a function of swallow interval. In the distal half of the esophagus, the amplitude decreased at swallow intervals of 8 s and shorter. At intervals of 8 and 4 s, dropouts of contractions that were obtained were most frequent in the distal esophagus and for the 4-s interval. At continuous swallows no contractions were obtained below the upper esophageal sphincter until the end of the swallow sequence, after which a peristaltic wave of high amplitude propagated along the esophagus. The peristaltic speed increased toward a level 5 cm above the lower esophageal sphincter. The peristaltic wave duration was approximately the same in different parts of the esophagus and at different swallow intervals. The findings indicate an impairment of esophageal transport function by short swallow intervals.

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Esophageal Peristalsis Disorders in ALS Patients with Dysphagia

Brain Sciences ◽

10.3390/brainsci10110820 ◽

2020 ◽

Vol 10 (11) ◽

pp. 820

Author(s):

Jerzy Tomik ◽

Klaudia Sowula ◽

Mateusz Dworak ◽

Kamila Stolcman ◽

Małgorzata Maraj ◽

...

Keyword(s):

Esophageal Manometry ◽

Clinical Presentation ◽

Upper Esophageal Sphincter ◽

Esophageal Peristalsis ◽

Resting Pressure ◽

Esophageal Sphincter ◽

Risk Of Aspiration ◽

Als Patients ◽

Low Amplitude ◽

Lateral Sclerosis

To detect the variations of esophageal peristalsis in amyotrophic lateral sclerosis (ALS) patients with predominantly bulbar or predominantly pseudobulbar clinical presentation by using esophageal manometry (EM). Fifteen ALS patients with pseudobulbar clinical presentation (PBP) and 13 patients with bulbar presentation (BP), fulfilling WFN Criteria, were studied. EM was performed in all subjects using a flexible catheter with solid-state transducers. Swallowing was initiated with 5 to 10 mL of water (wet swallows) and saliva (dry swallows) and repeated at 30 s intervals. The manometric parameters were measured automatically and visualized by the computer system. The tracings were analyzed using Synectics software. In PBP patients, an increase of resting pressure value in the upper esophageal sphincter (UES) >45 mmHg, a wave-like course of resting pressure, and toothed peristaltic waves were observed. In BP patients, a low amplitude of peristaltic waves <30 mmHg (mean: 17 ± 5) was recorded, without signs of esophageal motility disturbance at onset or during progression. EM procedure allows objectively distinguishing dysphagia in ALS patients due to bulbar syndrome from the dysphagia due to pseudobulbar syndrome. It is important to identify PBP patients because of their high risk of aspiration.

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Mechanisms of reflexes induced by esophageal distension

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.2001.281.5.g1246 ◽

2001 ◽

Vol 281 (5) ◽

pp. G1246-G1263 ◽

Cited By ~ 83

Author(s):

Ivan M. Lang ◽

Bidyut K. Medda ◽

Reza Shaker

Keyword(s):

Inflation Rate ◽

Upper Esophageal Sphincter ◽

Esophageal Peristalsis ◽

Air Volume ◽

Afferent Fibers ◽

Mucosal Layer ◽

Esophageal Sphincter ◽

Secondary Peristalsis ◽

Thoracic Vagotomy ◽

Decerebrate Cats

We investigated the mechanisms of esophageal distension-induced reflexes in decerebrate cats. Slow air esophageal distension activated esophago-upper esophageal sphincter (UES) contractile reflex (EUCR) and secondary peristalsis (2P). Rapid air distension activated esophago-UES relaxation reflex (EURR), esophago-glottal closure reflex (EGCR), esophago-hyoid distraction reflex (EHDR), and esophago-esophagus contraction reflex (EECR). Longitudinal esophageal stretch did not activate these reflexes. Magnitude and timing of EUCR were related to 2P but not injected air volume. Cervical esophagus transection did not affect the threshold of any reflex. Bolus diversion prevented swallow-related esophageal peristalsis. Lidocaine or capsaicin esophageal perfusion, esophageal mucosal layer removal, or intravenous baclofen blocked or inhibited EURR, EGCR, EHDR, and EECR but not EUCR or 2P. Thoracic vagotomy blocked all reflexes. These six reflexes can be activated by esophageal distension, and they occur in two sets depending on inflation rate rather than volume. EUCR was independent of 2P, but 2P activated EUCR; therefore, EUCR may help prevent reflux during peristalsis. All esophageal peristalsis may be secondary to esophageal stimulation in the cat. EURR, EHDR, EGCR, and EECR may contribute to belching and are probably mediated by capsaicin-sensitive, rapidly adapting mucosal mechanoreceptors. GABA-B receptors also inhibit these reflexes. EUCR and 2P are probably mediated by slowly adapting muscular mechanoreceptors. All six reflexes are mediated by vagal afferent fibers.

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Faculty Opinions recommendation of Differential relaxation and contractile responses of the human upper esophageal sphincter mediated by interplay of mucosal and deep mechanoreceptor activation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3217956.2902055 ◽

2010 ◽

Author(s):

Ivan Lang

Keyword(s):

Upper Esophageal Sphincter ◽

Contractile Responses ◽

Esophageal Sphincter

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Botulinum toxin treatment of upper esophageal sphincter hyperfunction

Operative Techniques in Otolaryngology-Head and Neck Surgery ◽

10.1016/j.otot.2004.03.005 ◽

2004 ◽

Vol 15 (2) ◽

pp. 107-109 ◽

Cited By ~ 2

Author(s):

Lucian Sulica ◽

Andrew Blitzer

Keyword(s):

Botulinum Toxin ◽

Upper Esophageal Sphincter ◽

Botulinum Toxin Treatment ◽

Esophageal Sphincter

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The Effect of Bolus Volume on Hyoid Kinematics in Healthy Swallowing

BioMed Research International ◽

10.1155/2014/738971 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Ahmed Nagy ◽

Sonja M. Molfenter ◽

Melanie Péladeau-Pigeon ◽

Shauna Stokely ◽

Catriona M. Steele

Keyword(s):

Peak Velocity ◽

Upper Esophageal Sphincter ◽

Healthy Population ◽

Bolus Volume ◽

Velocity Increase ◽

Movement Distance ◽

Hyoid Movement ◽

Laryngeal Vestibule ◽

Esophageal Sphincter ◽

Liquid Bolus

Hyoid movement in swallowing is biomechanically linked to closure of the laryngeal vestibule for airway protection and to opening of the upper esophageal sphincter. Studies suggest that the range of hyoid movement is highly variable in the healthy population. However, other aspects of hyoid movement such as velocity remain relatively unexplored. In this study, we analyze data from a sample of 20 healthy young participants (10 male) to determine whether hyoid movement distance, duration, velocity, and peak velocity vary systematically with increases in thin liquid bolus volume from 5 to 20 mL. The temporal correspondence between peak hyoid velocity and laryngeal vestibule closure was also examined. The results show that maximum hyoid position and peak velocity increase significantly for 20 mL bolus volumes compared to smaller volumes, and that the timing of peak velocity is closely linked to achieving laryngeal vestibule closure. This suggests that generating hyoid movements with increased power is a strategy for handling larger volumes.

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