Influence of vagal cooling on esophageal function.

1977 ◽  
Vol 232 (2) ◽  
pp. E159 ◽  
Author(s):  
J P Ryan ◽  
W J Snape ◽  
S Cohen
Keyword(s):  
Esophageal Wall ◽  
Vagal Activity ◽  
Esophageal Peristalsis ◽  
Esophageal Function ◽  
Balloon Distension ◽  
Esophageal Balloon ◽  
Cervical Vagotomy ◽  
Bilateral Vagotomy ◽  
Esophageal Sphincter ◽  
Vagal Cooling

Experiments were performed on adult opossums to determine the effect of decreased vagal activity on the esophageal peristalsis and lower esophageal sphincter (LES) relaxation associated with pharyngeal stimulation (PS) and esophageal balloon distension (ED). The cervical vagi were exposed and cooled (individually and bilaterally) to 3 degrees C using Dry Ice and alcohol-chilled saline. Unilateral vagal cooling had no effect on the esophageal peristalsis or LES relaxation associated with PS or ED. Similarly, bilateral vagal cooling did not alter the peristalsis and sphincter relaxation induced by ED. Bilateral vagal cooling, on the other hand, significantly decreased the incidence of peristalsis and the sphincter relaxation associated with PS. Studies were also performed to examine the effect of unilateral and bilateral vagotomy of esophageal function. Neither right nor left cervical vagotomy affected esophageal peristalsis or LES relaxation, regardless of the model of stimulation. Bilateral vagotomy, however, diminished the esophageal response to PS but was without effect on the peristalsis and LES relaxation produced in response to ED. From the studies we condlude: 1) the vagus nerve is of primary importance in regulating the esophageal response to PS, and 2) local neuromuscular factors within the esophageal wall appear sufficient to initiate and maintain an esophageal response to distension.

In vivo and in vitro influence of human recombinant hemoglobin on esophageal function

1995 ◽  
Vol 268 (3) ◽  
pp. G443-G450 ◽  
Author(s):  
S. Chakder ◽  
G. J. Rosenthal ◽  
S. Rattan
Keyword(s):  
Oxygen Carrier ◽  
Electrical Field Stimulation ◽  
Esophageal Peristalsis ◽  
Esophageal Function ◽  
Significant Impairment ◽  
Esophageal Sphincter ◽  
Peristaltic Contractions

The purpose of the present investigation was to examine the influence of a nitric oxide scavenger, hemoglobin (Hb), on esophageal function. Intraluminal pressures of anesthetized opossums were recorded from lower esophageal sphincter (LES) and 1, 5, and 9 cm above the LES. The influence of a representative Hb-based oxygen carrier was examined on swallowing-induced esophageal peristalsis and LES relaxation. In in vitro studies, LES relaxation and esophageal peristaltic contractions were induced by the activation of nonadrenergic noncholinergic (NANC) neurons by electrical field stimulation (EFS). Hb caused significant impairment in swallowing- and EFS-induced LES relaxation and a significant increase in the speed of esophageal peristalsis. In some experiments, swallowing caused simultaneous contractions in the esophagus following Hb administration. Although Hb completely blocked LES relaxation by NO and significantly attenuated that by NANC nerve stimulation, it had no significant effect on isoproterenol-induced LES relaxations. The data support the role of NO in LES relaxation and esophageal peristalsis. This esophageal model may be important in understanding the influence of NO inhibitors and scavengers in gastrointestinal motility.

Determinants of lower esophageal sphincter relaxation induced by esophageal balloon distension in humans

1996 ◽  
Vol 270 (6) ◽  
pp. G1022-G1027 ◽  
Author(s):  
M. W. Manthey ◽  
B. T. Massey ◽  
R. C. Arndorfer ◽  
W. J. Hogan
Keyword(s):  
Lower Esophageal Sphincter ◽  
Healthy Subjects ◽  
Relaxation Response ◽  
Vagal Modulation ◽  
Lower Esophageal Sphincter Relaxation ◽  
Balloon Distension ◽  
Esophageal Balloon ◽  
Large Balloon ◽  
Esophageal Sphincter ◽  
Different Diameters

The determinants of the lower esophageal sphincter relaxation response to esophageal distension have not previously been systematically examined in humans. In this study, 14 healthy subjects were tested using a manometry catheter with a sleeve device and three balloons spaced 5 cm apart. Subjects had up to five distensions with each balloon at four different diameters and two different durations of inflation. The results indicated that 1,170 separate distensions were available for analysis. Sphincter relaxation occurred more frequently (P < 0.005) with larger balloon diameters, yet occurred in only 84% of inflations at the largest diameter. Sphincter relaxation was more often observed with the proximal balloon (P < 0.005) during longer distensions (P < 0.05) and when esophageal contractions occurred above the balloon (P < 0.005). Once sphincter relaxation occurred, its magnitude was essentially independent of balloon site and diameter, distension duration, and the presence of proximal contractions. In conclusion, even large balloon distensions do not uniformly produce or maintain lower esophageal sphincter relaxation. Sphincter relaxation is more likely with proximal esophageal distension. The association of sphincter relaxation with vagally mediated proximal contractions suggests vagal modulation of this response.

Effect of aging on the secondary esophageal peristalsis: presbyesophagus revisited

1995 ◽  
Vol 268 (5) ◽  
pp. G772-G779 ◽  
Author(s):  
J. Ren ◽  
R. Shaker ◽  
M. Kusano ◽  
B. Podvrsan ◽  
N. Metwally ◽  
...  
Keyword(s):  
The Elderly ◽  
Air Injection ◽  
Esophageal Peristalsis ◽  
Healthy Elderly ◽  
Balloon Distension ◽  
Esophageal Sphincter ◽  
Human Esophagus ◽  
Secondary Peristalsis ◽  
Frequency Of Stimulation ◽  
Stimulation Of

In this study we determined the effect of aging on the capability of the human esophagus to generate secondary peristalsis. We studied nine healthy young (35 +/- 2 yr, 25-45 yr) and nine healthy elderly (74 +/- 3 yr, 70-83 yr) volunteers. We stimulated secondary peristalsis by intraesophageal air injection and balloon distension. All young volunteers exhibited secondary esophageal peristalsis. In four elderly volunteers, secondary peristalsis could not be elicited with injection of any of the tested air volumes. Frequency of stimulation of secondary peristalsis and lower esophageal sphincter (LES) relaxation in response to intraesophageal air distension in the elderly was significantly lower than that in the young (P < 0.01). Stimulation of secondary peristalsis by balloon distension was less consistent compared with the air injection. In conclusion, 1) in the elderly, compared with the young, secondary esophageal peristalsis is either absent or is evoked less frequently after esophageal distension, and complete LES relaxation in response to esophageal air distension is less frequent, and 2) in both young and elderly, secondary esophageal peristalsis is induced more frequently after generalized esophageal distension by air than its segmental distension by a balloon.

Cerebral potentials evoked by esophageal distension in human

1990 ◽  
Vol 259 (6) ◽  
pp. G955-G959 ◽  
Author(s):  
A. J. Smout ◽  
M. S. DeVore ◽  
D. O. Castell
Keyword(s):  
Evoked Potentials ◽  
Healthy Volunteers ◽  
Balloon Inflation ◽  
Balloon Distension ◽  
Stimulus Perception ◽  
Esophageal Balloon ◽  
Cerebral Evoked Potentials ◽  
Esophageal Sphincter ◽  
Human Esophagus

Recent studies have shown that cerebral evoked potentials (EPs) can be recorded after balloon distension of the human esophagus. The aim of this study was to evaluate the characteristics of these viscerosensory EPs and to investigate the relations between these EPs and perception of esophageal distension. Nineteen healthy volunteers (22-60 yr old) were studied. A balloon positioned 5 cm above the lower esophageal sphincter was inflated 10 times each minute. EPs recorded from four midline scalp electrodes were averaged for 50 and 100 inflation cycles. A clearly defined triphasic (negative-positive-negative) EP was recorded in all subjects and from all four recording sites when a volume leading to definite sensation and rapid balloon inflation (170 ml/s) was used. The latencies of the peaks were 231 +/- 7 (N1), 303 +/- 7 (P1), and 379 +/- 8 ms (N2). No significant correlation between stimulus perception and latency was found. The amplitude and quality of the EPs (scored by 3 blinded observers) increased significantly (P less than 0.01, ANOVA) with increasing sensation. Slow balloon inflation (30 ml/s) was significantly less effective in evoking EPs than rapid inflation (P less than 0.01). The EPs evoked by 100 inflations were not significantly clearer than those evoked by 50 inflations. It is concluded that the ability to record cerebral potentials evoked by esophageal balloon distension is related to the rate of balloon inflation and to the level of awareness of the stimulus.

Comparison of primary and secondary esophageal peristalsis in humans: effect of atropine

1991 ◽  
Vol 260 (1) ◽  
pp. G52-G57 ◽  
Author(s):  
W. G. Paterson ◽  
T. T. Hynna-Liepert ◽  
M. Selucky
Keyword(s):  
Neural Pathways ◽  
Esophageal Peristalsis ◽  
Healthy Male ◽  
Double Blind ◽  
Primary Peristalsis ◽  
Lower Amplitude ◽  
Catheter System ◽  
The Subject ◽  
Esophageal Sphincter ◽  
Secondary Peristalsis

To determine whether physiological differences exist between primary (swallow-induced) and secondary (distension-induced) peristalsis in humans, 10 healthy male volunteers underwent esophageal manometry on 2 consecutive days using a perfused intraluminal catheter system that incorporated a latex balloon. Initially the catheter was positioned so that the balloon was centered 16 cm above the lower esophageal sphincter (LES), and intraluminal pressures were recorded 21, 11, 6, and 1 cm above the LES. After a series of wet swallows, dry swallows, and balloon distensions, the catheter was repositioned so that the balloon was 6 cm above the LES and pressures were recorded 1 and 11 cm above the LES. A series of balloon distensions were repeated in this position, and the subject was then given either atropine (10 micrograms/kg iv) or placebo in a double-blind randomized fashion (on consecutive days). The protocol was then repeated in reverse order. Distension-induced responses aboral to the balloon with the balloon located 16 cm above the LES were 1) of lower amplitude, 2) more often nonperistaltic, and 3) less atropine sensitive than swallow-induced contractions at comparable sites. With the balloon located distally (6 cm above LES) contractions induced at the 11-cm site (i.e., orad to the balloon) were much more atropine sensitive than contractions induced at the same site when the balloon was located proximally (i.e., 16 cm above LES). These data suggest that, contrary to previous reports, secondary peristalsis differs significantly from primary peristalsis. Furthermore, atropine differentially effects these two types of peristalsis, suggesting that the neural pathways involved are dissimilar.

scholarly journals Morphological and functional evaluation of distal esophagus of rabbits submitted to esophageal infusion with caustic soda

2008 ◽  
Vol 23 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Maria Aparecida Coelho de Arruda Henry ◽  
Carlos Eduardo Brossi Pelissari ◽  
Lídia Raquel Carvalho
Keyword(s):  
Caustic Soda ◽  
Emergency Situation ◽  
Solution Concentration ◽  
Esophageal Wall ◽  
Functional Evaluation ◽  
Contraction Amplitude ◽  
Morphological Alterations ◽  
Morphological Evaluation ◽  
Esophageal Sphincter ◽  
Ingestion Of Caustic Substances

The ingestion of caustic substances is an important emergency situation, because of its serious consequences. PURPOSE: To study morphological and functional alterations of the esophagus in rabbits submitted to esophageal infusion of caustic soda (NaOH). METHODS: The 88 rabbits studied were divided into 4 groups: G1 (n=22) were submitted to esophageal infusion with distilled water. G2, G3, and G4 were submitted to esophageal infusion of 2%, 4% and 6% NaOH respectively. Morphological alterations were studied in 12 animals from each group and manometric alterations in the remaining 10. An analysis was made of lower esophageal sphincter (LES) pressure, number and amplitude of contractions in the distal third of the esophagus. These studies were performed before (moment M1) and at 30 minutes, 6 hours, and 24 hours after (moments M2, M3, and M4, respectively) esophageal infusion. RESULTS: Morphological evaluation: G1 - no alterations; G2 - edema, hyperemia, and ecdysis; G3 - enlarged calibre of esophagus, ulcers, ecdysis of mucosa; G4 - lesions similar to G3, but more intense, areas of extensive hemorrhage at M3 and M4. Functional evaluation: LES was higher at M2; the number of distal third lower esophageal contractions in G3, and G4 was lower; and the contraction amplitude was lower in G4. CONCLUSIONS: 1) Esophageal infusion with caustic soda in rabbits is a good experimental model for studying caustic esophagites. 2) Esophageal infusion with NaOH caused lesions in the esophageal wall, with gravity proportional to solution concentration; 3) Infusion caused LES spasm at M2, and reduced both contraction number and amplitude in the distal third of the esophagus.

Stimulation of esophageal mechanoreceptors is dependent on rate and duration of distension

1994 ◽  
Vol 267 (1) ◽  
pp. G115-G118 ◽  
Author(s):  
P. Nguyen ◽  
D. O. Castell
Keyword(s):  
Lower Esophageal Sphincter ◽  
Inflation Rate ◽  
Sensory Perception ◽  
Sensory Awareness ◽  
Balloon Distension ◽  
Esophageal Sphincter ◽  
Stimulation Of

We randomly compared rapid (170 ml/s) and slow (0.7 ml/s) rates of balloon distension in 19 volunteers (9 male, 10 female) using a latex balloon (length 3 cm) positioned 5 cm proximal to the lower esophageal sphincter. The balloon was inflated/deflated (1-s dwell; 5- to 10-s interval) with increasing 2-ml volumes during rapid inflation studies and progressively distended during slow inflation studies while subjects blindly indicated feeling, rated as follows: 0 (no sensation); 1 (aware of balloon, but no discomfort); 2 (pain or discomfort). In a second set of studies, the balloon was left inflated for 60 s at a volume 2 ml below that producing sensation 1, and time until a change in sensation was recorded. This was repeated at a volume 2 ml below that producing sensation 2. Mean volume to sensation 1 with slow inflation was 14.6 +/- 1.2 ml (SE) and with rapid inflation was 8.5 +/- 0.8 ml (P < 0.001). Mean volume to sensation 2 with slow inflation was 23.7 +/- 1.0 ml and with rapid inflation was 17.4 +/- 1.0 ml (P < 0.001). With sustained (60 s) inflation, most subjects noted increasing sensation, independent of initial inflation rate. We conclude that distal esophageal sensory perception (both awareness and discomfort) is dependent on rate of stimulation of mechanoreceptors. A sustained distension stimulus appears to recruit additional receptors and increase the level of sensory awareness.

Effects of Peroral Endoscopic Myotomy on Esophageal Function in the Treatment of Achalasia

2020 ◽  
pp. 155335062091313
Author(s):  
Bai Cang Zou ◽  
Li Zhang ◽  
Bin Qin ◽  
Shen Hao Wang ◽  
Yan Cheng ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Clinical Symptoms ◽  
Operation Time ◽  
Peroral Endoscopic Myotomy ◽  
Esophageal Stent ◽  
Sphincter Pressure ◽  
Esophageal Function ◽  
Eckardt Score ◽  
Endoscopic Myotomy ◽  
Esophageal Sphincter

Peroral endoscopic myotomy (POEM) is a new technique to treat achalasia, but the effects on esophageal motor function and structure are still unclear. This study aimed to examine the esophageal function and anatomical changes of patients with achalasia treated with POEM. This was a retrospective study of 43 patients with achalasia treated with POEM between January 2013 and January 2016 at the Second Affiliated Hospital of Xi’an Jiaotong University. The patients were grouped as previous treatments for achalasia (n = 19) versus no previous treatment (n = 24). Surgical success (defined as Eckardt score ≤3 points or decreased by >3 points compared with baseline), recurrence, and reintervention were analyzed. Three patients (7.0%) were Eckardt grade I, 16 (37.2%) were grade II, and 24 (55.8%) were grade III. Operation time was 35 to 150 (median = 49) minutes. Both groups showed improvements in the Eckardt score after surgery (both P < .001), without a difference between the 2 groups ( P = .749). The maximal mean diameter of the esophagus was reduced, and the lower esophageal sphincter pressure was improved after surgery (both groups, all P < .001), without difference between the 2 groups (all P > .05). One case of failure was probably due to the presence of an esophageal stent. POEM has a high success rate and is possibly unaffected by previous treatments, except maybe stent implantation. Clinical symptoms of achalasia are significantly relieved by POEM; the function of the esophageal sphincter and the esophagus structure are improved. Previous esophageal stent implantation could increase failure likelihood, but this will have to be confirmed.

Responses of ferret lower esophageal sphincter to 5-hydroxytryptamine: pathways and receptor subtypes

1995 ◽  
Vol 268 (6) ◽  
pp. G1004-G1011 ◽  
Author(s):  
L. A. Blackshaw ◽  
V. Nisyrios ◽  
J. Dent
Keyword(s):  
Lower Esophageal Sphincter ◽  
Splanchnic Nerve ◽  
Lower Esophageal Sphincter Pressure ◽  
Receptor Subtypes ◽  
Sphincter Pressure ◽  
In Series ◽  
Bilateral Vagotomy ◽  
Excitatory Component ◽  
Esophageal Sphincter ◽  
Greater Splanchnic Nerve

In urethananesthetized ferrets, basal lower esophageal sphincter pressure (LESP) was unaffected by the 5-hydroxytryptamine3 (5-HT3) receptor antagonist granisetron (0.5 mg/kg) or by greater splanchnic nerve section (GSX), but increased after bilateral vagotomy. Peripheral vagal nerve stimulation caused LES relaxation, often followed by a brief contraction and a prolonged inhibition of LESP. Close intra-arterial injection of 5-HT (5-100 micrograms) had a biphasic effect on LESP, with a brief drop followed by a prolonged increase. Granisetron (0.5 mg/kg i.v.) abolished the initial relaxation and revealed an earlier peak of excitation. This was not influenced by subsequent vagotomy and GSX. In a series of eight additional experiments (series 2), granisetron was given after vagotomy and GSX. In series 2, 5-HT-induced relaxation was unaffected by vagotomy but was significantly reduced after GSX and was further reduced after granisetron, indicating that 5-HT3 receptor mechanisms may lie on a sympathetic neural pathway. Vagotomy had no effect on the excitatory component. GSX had no effect on the amplitude of excitation, but reduced its latency. Granisetron had no further effect on excitation in series 2. In a separate series of 13 experiments (series 3), the excitatory component of the LES response to 5-HT was abolished by ketanserin (2.5 mg/kg i.v.) , after which only relaxation occurred. Both 5-HT2 and 5-HT3 antagonists in combination abolished all effects of 5-HT on LESP. Atropine (400 micrograms/kg i.v., n = 7) had no effect on 5-HT-induced LES responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Sign in / Sign up

Export Citation Format

Share Document