Absence of a deglutitive inhibition equivalent with secondary peristalsis

2005 ◽  
Vol 288 (4) ◽  
pp. G671-G676 ◽  
Author(s):  
John E. Pandolfino ◽  
Guoxiang Shi ◽  
Qing Zhang ◽  
Peter J. Kahrilas
Keyword(s):  
Smooth Muscle ◽  
Lower Esophageal Sphincter ◽  
Intrinsic Property ◽  
Air Injection ◽  
Success Rates ◽  
Primary Peristalsis ◽  
No Inhibition ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter ◽  
Secondary Peristalsis

This study aimed to determine the interactions between closely paired swallow-induced primary peristalsis (PP) and air injection-induced secondary peristalsis (SP). Ten subjects (7 men, 18–42 yr) were studied using a catheter, including two sleeves (upper and lower esophageal sphincters), a midesophageal infusion port, and seven esophageal and two pharyngeal recording sites. Ten iterations of PP and SP were induced by 5-ml water swallows and 20-ml intraesophageal air injections, respectively. Thereafter, the interactions between PP and SP, separated by 1- to 12-s intervals, were studied in all four possible sequences: paired swallows, swallow preceded by air injection, air injection preceded by swallow, and paired air injections. Tracings were analyzed for lower esophageal sphincter relaxation, presence and integrity of peristalsis, and event interaction. Eight subjects with success rates of both ≥90% PP and ≥80% SP were analyzed (PP 97 ± 2%, SP 90 ± 3%). During paired PP interactions and SP followed by PP, the first sequence was inhibited by the second with intervals < 4–6 s. However, no inhibition of the first peristaltic sequence was found in either PP followed by SP trials or SP followed by air injection. In contrast to swallowing or proximal esophageal distention, air injection into the lumen of the midesophagus does not inhibit an ongoing peristaltic event. Being that the elicitation of SP in the smooth muscle esophagus is intramurally mediated, this suggests that deglutitive inhibition is a centrally mediated phenomenon rather than an intrinsic property of peristalsis.

scholarly journals Lower esophageal sphincter relaxation reflex kinetics: effects of peristaltic reflexes and maturation in human premature neonates

2010 ◽  
Vol 299 (6) ◽  
pp. G1386-G1395 ◽  
Author(s):  
Eneysis M. Pena ◽  
Vanessa N. Parks ◽  
Juan Peng ◽  
Soledad A. Fernandez ◽  
Carlo Di Lorenzo ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Response Latency ◽  
Postnatal Maturation ◽  
Premature Neonates ◽  
Relaxation Period ◽  
Peristaltic Reflex ◽  
Primary Peristalsis ◽  
Lower Esophageal Sphincter Relaxation ◽  
Sensory Motor ◽  
Esophageal Sphincter

We defined the sensory-motor characteristics of the lower esophageal sphincter relaxation (LESR) (stimulus threshold volume, response onset, and relaxation period, relaxation magnitude, nadir) during maturation in human neonates. We hypothesized that LESR kinetics differs during maturation and with peristaltic reflex type. Basal and adaptive esophageal motility testing was performed ( N = 20 premature neonates) at 34.7 and 39.1 wk ( time 1 and time 2). Effects of midesophageal provocation with graded stimuli ( N = 1,267 stimuli, air and liquids) on LESR kinetics during esophagodeglutition response (EDR) and secondary peristalsis (SP) were analyzed by mixed models. Frequency of LESR with basal primary peristalsis were different during maturation ( P = 0.03). During adaptive responses with maturation, 1) the frequencies of peristaltic reflexes and LESR were similar; 2) liquid stimuli resulted in a shorter LESR response latency and LESR nadir and greater LESR magnitude (all P < 0.05); 3) media differences were noted with LESR response latency (air vs. liquids, P < 0.02); and 4) infusion flow rate-LESR were different ( P < 0.01 for air and liquids). Mechanistically, 1) frequency of LESR was greater during peristaltic reflexes at both times (vs. none, P < 0.0001); 2) LESR response latency, duration, and time to complete LESR were longer with EDR (all P < 0.05, vs. SP at time 2); and 3) graded stimulus volume LESR were different for air and liquids ( P < 0.01). In conclusion, sensory-motor characteristics of LESR depend on the mechanosensitive properties of the stimulus (media, volume, flow), type of peristaltic reflex, and postnatal maturation. Maturation modulates an increased recruitment of inhibitory pathways that favor LESR.

Isolated Lower Esophageal Sphincter Relaxation as ``Wave-Suppressed'' Secondary Peristalsis

Dysphagia ◽  
1997 ◽  
Vol 12 (4) ◽  
pp. 207-211 ◽  
Author(s):  
Susan R. Orenstein ◽  
Carlo DiLorenzo ◽  
David M. Orenstein ◽  
Theresa M. Shalaby ◽  
Lee G. Deneault ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter ◽  
Secondary Peristalsis

Transient Lower Esophageal Sphincter Relaxation in Morbid Obesity

2009 ◽  
Vol 19 (5) ◽  
pp. 595-600 ◽  
Author(s):  
J. H. Schneider ◽  
M. Küper ◽  
A. Königsrainer ◽  
B. Brücher
Keyword(s):  
Morbid Obesity ◽  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter

scholarly journals THE PARTICIPATION OF THE NITRERGIC PATHWAY IN INCREASED RATE OF TRANSITORY RELAXATION OF LOWER ESOPHAGEAL SPHINCTER INDUCED BY RECTAL DISTENSION IN DOGS

2014 ◽  
Vol 51 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Michel Santos PALHETA ◽  
José Ronaldo Vasconcelos da GRAÇA ◽  
Armênio Aguiar dos SANTOS ◽  
Liziane Hermógenes LOPES ◽  
Raimundo Campos PALHETA JÚNIOR ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Lower Esophageal Sphincter ◽  
Esophageal Motility ◽  
Control Group ◽  
Rectal Distension ◽  
Evaluation Protocol ◽  
Lower Esophageal Sphincter Relaxation ◽  
Respective Control Group ◽  
Esophageal Sphincter ◽  
Pre Treatment

ContextThe rectal distension in dogs increases the rate of transitory lower esophageal sphincter relaxation considered the main factor causing gastroesophageal reflux.ObjectivesThe aim of this study was evaluate the participation of the nitrergic pathway in the increased transitory lower esophageal sphincter relaxation rate induced by rectal distension in anesthetized dogs.MethodsMale mongrel dogs (n = 21), weighing 10-15 kg, were fasted for 12 hours, with water ad libitum. Thereafter, they were anesthetized (ketamine 10 mg.Kg-1+ xylazine 20 mg.Kg-1), so as to carry out the esophageal motility evaluation protocol during 120 min. After a 30-minute basal period, the animals were randomly intravenous treated whith: saline solution 0.15M (1ml.Kg-1), L-NAME (3 mg.Kg-1), L-NAME (3 mg.Kg-1) + L-Arginine (200 mg.Kg-1), glibenclamide (1 mg.Kg-1) or methylene blue (3 mg.Kg-1). Forty-five min after these pre-treatments, the rectum was distended (rectal distension, 5 mL.Kg-1) or not (control) with a latex balloon, with changes in the esophageal motility recorded over 45 min. Data were analyzed using ANOVA followed by Student Newman-Keuls test.ResultsIn comparison to the respective control group, rectal distension induces an increase in transitory lower esophageal sphincter relaxation. Pre-treatment with L-NAME or methylene blue prevents (P<0.05) this phenomenon, which is reversible by L-Arginine plus L-NAME. However, pretreating with glibenclamide failed to abolish this process.ConclusionsTherefore, these experiments suggested, that rectal distension increases transitory lower esophageal sphincter relaxation in dogs via through nitrergic pathways.

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.

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