Variability of lower esophageal sphincter pressure in the fasted unanesthetized opossum

1985 ◽  
Vol 248 (4) ◽  
pp. G398-G406
Author(s):  
R. H. Holloway ◽  
E. Blank ◽  
I. Takahashi ◽  
W. J. Dodds ◽  
W. J. Hogan ◽  
...  
Keyword(s):  
Phase I ◽  
Lower Esophageal Sphincter ◽  
Gastric Antrum ◽  
Phase Iii ◽  
In Vivo Studies ◽  
Intraluminal Pressure ◽  
Myoelectric Activity ◽  
Sphincter Pressure ◽  
Esophageal Sphincter ◽  
Cyclic Changes

The opossum has served as a useful animal model for in vivo studies of lower esophageal sphincter (LES) function. Previous investigations, however, have been confined to studies on anesthetized animals. In 10 opossums we investigated LES pressure during fasting cycles of the gastrointestinal migrating myoelectric complex (MMC) and examined the influences of anesthesia and feeding on LES pressure. Intraluminal pressure from the esophageal body, LES, and gastric antrum was recorded by a manometric assembly that incorporated a sleeve device. Myoelectric activity was recorded from the gastric antrum and duodenum via implanted electrodes. MMCs were readily recorded from all animals. MMC cycle length was 86 +/- 2.9 (SE) min. The LES exhibited cyclic changes in intraluminal pressure that occurred in synchrony with the gastric MMC cycle. During phase I of the gastric MMC cycle, LES pressure was essentially stable, although intermittent spontaneous oscillations at 3-4/min were sometimes noted. Forceful phasic LES contraction started during phase II of the gastric MMC, became maximal during phase III, and disappeared during phase I. The MMC-related phasic LES contraction occurred at a maximal rate of 1.4 +/- 0.05/min with amplitudes of 60-150 mmHg and were temporally associated with spike bursts and contractions in the gastric antrum. Pentobarbital sodium-induced anesthesia abolished MMC-related phasic LES activity and caused a transient rise in basal sphincter pressure. Phasic LES activity was also inhibited by atropine and feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of gastric antrum on regulation of lower esophageal sphincter pressure in the dog.

1978 ◽  
Vol 234 (2) ◽  
pp. E157
Author(s):  
H R Koelz ◽  
A P Hollinger ◽  
H Säuberli ◽  
F Largiadèr ◽  
R Siewert ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Gastric Antrum ◽  
Sphincter Pressure ◽  
Esophageal Sphincter

Effects of alterations in bolus viscosity on esophageal peristalsis in humans

1988 ◽  
Vol 254 (1) ◽  
pp. G8-G11 ◽  
Author(s):  
C. P. Dooley ◽  
B. Schlossmacher ◽  
J. E. Valenzuela
Keyword(s):  
Lower Esophageal Sphincter ◽  
Lower Esophageal Sphincter Pressure ◽  
Intraluminal Pressure ◽  
Sphincter Pressure ◽  
Esophageal Peristalsis ◽  
Catheter System ◽  
Bolus Viscosity ◽  
Esophageal Sphincter ◽  
Infused Catheter System ◽  
Initial Change

The effect of increased bolus viscosity on esophageal peristaltic function was studied in six healthy volunteer subjects. Intraluminal pressure events were measured with an infused catheter system and lower esophageal sphincter pressure was monitored continuously with a Dent sleeve. Boluses with viscosities of 2.5, 8.7, 48, and 860 centipoise (cP) were compared with a water bolus. Increasing bolus viscosity to 48 and 860 cP elicited a slowing of wave velocity, an increase in wave duration, and a prolongation of lower esophageal sphincter relaxation. The initial change noted at lower viscosities was an increased duration of contraction wave. Maximal changes were noted at the 48 cP bolus. In conclusion, increased bolus viscosity significantly alters human esophageal peristalsis. These changes may be mediated by esophageal stretch reflexes or by the intrinsic properties of the esophageal musculature or both.

Electrically coupled intrinsic responses of feline lower esophageal sphincter

1982 ◽  
Vol 243 (5) ◽  
pp. G415-G423 ◽  
Author(s):  
J. C. Reynolds ◽  
A. Ouyang ◽  
S. Cohen
Keyword(s):  
Lower Esophageal Sphincter ◽  
Spike Activity ◽  
Pressure Rise ◽  
Myoelectric Activity ◽  
Sphincter Pressure ◽  
Cervical Vagotomy ◽  
Resting Pressure ◽  
Esophageal Sphincter ◽  
Pressure Changes ◽  
Dose Dependent

Intraluminal pressures and serosal myoelectric activity were recorded simultaneously from the esophagus, lower esophageal sphincter (LES), and stomach of chloralose-anesthetized cats. The LES demonstrated intermittent spike activity basally without slow waves and was distinct from esophagus and fundus. LES spike activity was not correlated with basal sphincter pressure. Dose-dependent increases in both spikes and pressure occurred with bethanechol, phenylephrine, or pentagastrin. Increased spike activity preceded the onset of the pressure rise and peaked during the rise in pressure. Changes in LES pressure and spike activity following these agents were correlated closely (r = 0.92, P less than 0.01). Atropine and isoproterenol inhibited pressure and spike activity similarly. Intrinsic reflexes to endogenous stimuli gave parallel spike and pressure changes. Distal esophageal acidification produced an increase in LES pressure that was correlated with increased spike activity. LES spike activity and pressure were inhibited similarly by antral distension or gastric acidification. Dissection of the distal esophagus from the diaphragm or bilateral cervical vagotomy had no effect on either LES spike activity or pressure. These studies indicate that a) LES myoelectric activity consists of spike discharges that are not correlated to resting pressure, b) abrupt changes in sphincter pressure following either intrinsic reflexes or neurohormonal agents are closely associated with similar changes in spike activity, and c) spike activity and sphincter pressure are intrinsic to the LES.

Food and Gastroesophageal Reflux Disease

2019 ◽  
Vol 26 (19) ◽  
pp. 3497-3511 ◽  
Author(s):  
Teodora Surdea-Blaga ◽  
Dana E. Negrutiu ◽  
Mariana Palage ◽  
Dan L. Dumitrascu
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Lower Esophageal Sphincter ◽  
Reflux Disease ◽  
Current Knowledge ◽  
Positive Association ◽  
Sphincter Pressure ◽  
Low Carbohydrate Diet ◽  
Reflux Symptoms ◽  
Esophageal Sphincter

Gastroesophageal reflux disease is a chronic condition with a high prevalence in western countries. Transient lower esophageal sphincter relaxation episodes and a decreased lower esophageal sphincter pressure are the main mechanisms involved. Currently used drugs are efficient on reflux symptoms, but only as long as they are administered, because they do not modify the reflux barrier. Certain nutrients or foods are generally considered to increase the frequency of gastroesophageal reflux symptoms, therefore physicians recommend changes in diet and some patients avoid bothering foods. This review summarizes current knowledge regarding food and gastroesophageal reflux. For example, fat intake increases the perception of reflux symptoms. Regular coffee and chocolate induce gastroesophageal reflux and increase the lower esophageal exposure to acid. Spicy foods might induce heartburn, but the exact mechanism is not known. Beer and wine induce gastroesophageal reflux, mainly in the first hour after intake. For other foods, like fried food or carbonated beverages data on gastroesophageal reflux is scarce. Similarly, there are few data about the type of diet and gastroesophageal reflux. Mediterranean diet and a very low carbohydrate diet protect against reflux. Regarding diet-related practices, consistent data showed that a “short-meal-to-sleep interval” favors reflux episodes, therefore some authors recommend that dinner should be at least four hours before bedtime. All these recommendations should consider patient’s weight, because several meta-analyses showed a positive association between increased body mass index and gastroesophageal reflux disease.

PS01.008: LOWER ESOPHAGEAL SPHINCTER PRESSURE (LESP) AS A MEASURE OF ANTI-REFLUX BARRIER IN PATIENTS WITH HIATUS HERNIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 51-52
Author(s):  
Balazs Kovacs ◽  
Takahiro Masuda ◽  
Ross Bremner ◽  
Sumeet Mittal
Keyword(s):  
Hiatal Hernia ◽  
Lower Esophageal Sphincter ◽  
Hiatus Hernia ◽  
Conflicts Of Interest ◽  
Holding Time ◽  
Sphincter Pressure ◽  
Total Acid ◽  
Inversion Point ◽  
Type C ◽  
Esophageal Sphincter

Abstract Background Hiatus Hernia (HH), with its anatomical/physiological derangement of esophagogastric junction (EGJ) barrier function is a risk factor for pathological gastro-esophageal reflux (GER). However, a subset of patients with HH do not have reflux. The aim of this study is to explore Lower Esophageal sphincter parameters and GER across the EGJ in patients with manometeric type C hiatal hernia (LES-Crural Diaphragm separation > 1cm, and Pressure Inversion Point below LES). Methods An IRB approved, prospectively maintained esophageal testing registry was queried to identify patients who underwent High Resolution Manometry and 24h pH study (within 1 week) between 11/01/2016 and 11/01/2017. HRM characteristics of the EGJ (LES-CD separation, overall length, LESP, LESPI), 24 hour pH score, and pH < 4 holding time were extracted. Spearman's Rho correlation was calculated for all parameters and Receiver operating characteristic (ROC) curve was applied for parameters with significant correlation. Results A total of 1139 patients underwent HRM during the study period, of these 416 also had 24 hour pH study. 76 Patients met criteria for EGJ morphology Type C. After excluding patients with major disorders of peristalsis (16) the remaining 60 patients form the cohort of this study. Hiatal hernia size, overall length of LES, and LESPI did not correlate with 24 hour pH score or pH < 4 holding time. LESP had a significant negative correlation both with 24 hour pH score (R: -0.322; P = 0.011), and total acid holding time (R: -0.348; P = 0.006). A LESP cut-off value of 24.4 mmHg had a sensitivity of 53.8% and a Specificity of 91.2% for predicting pathological reflux. Conclusion A higher LESP (> 24.4 mmHg) appears to provide an effective barrier to pathological GER even when normal EGJ function is compromised by a hiatal hernia. Disclosure All authors have declared no conflicts of interest.

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.  

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