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.

Novel Prokinetic Acotiamide Reduces Transient Lower Esophageal Sphincter Relaxation in Healthy Subjects

Digestion ◽  
2015 ◽  
Vol 92 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Hiroshi Yamashita ◽  
Atsushi Kanamori ◽  
Takumi Fukuchi ◽  
Masahiro Tsujimae ◽  
Akio Koizumi ◽  
...  
Keyword(s):  
Lower Esophageal Sphincter ◽  
Healthy Subjects ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter

Characteristics of transient lower esophageal sphincter relaxation in humans

1987 ◽  
Vol 252 (5) ◽  
pp. G636-G641 ◽  
Author(s):  
R. K. Mittal ◽  
R. W. McCallum
Keyword(s):  
Electrical Activity ◽  
Lower Esophageal Sphincter ◽  
Healthy Subjects ◽  
Acid Reflux ◽  
Equal Frequency ◽  
Mylohyoid Muscle ◽  
Postprandial State ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter ◽  
Esophageal Contraction

Transient lower esophageal sphincter relaxations (TLESR) were studied in 10 normal healthy subjects. Electrical activity of mylohyoid muscle measured by an electromyogram (MEMG), pressures from pharynx, three esophageal sites, lower esophageal sphincter, and stomach were simultaneously recorded for 1 h, while fasting and 3 h after an 850 kcal meal. Reflux of acid into esophagus and/or occurrence of belching accompanying a TLESR was also monitored. TLESRs occurred with an equal frequency in fasting and postprandial state (6.2 vs. 6.4 h). However, frequency of an acid reflux during a TLESR was much greater postprandially than after fasting (44.8 vs. 9.6%). Belching coincided with 8% of TLESRs. A small MEMG complex and a small pharyngeal complex were present at onset of TLESR in 41.6 and 26.9% of instances, respectively. TLESRs were then categorized as either postswallow, if it occurred within 10 s of a preceding swallow-induced LES relaxation, or isolated, if its onset to previous swallow was greater than 10 s. Esophageal contractions were noticed at onset of 84% of isolated TLESRs. When present at two distal sites, this contraction was always of a simultaneous nature. Esophageal contractions at onset of postswallow TLESR were less frequent (33.3%) but when present were usually observed at the proximal esophageal site. At completion of a TLESR, the LES never recovered without an associated esophageal contraction, the latter was either swallow mediated or a spontaneous simultaneous esophageal contraction. Our data indicate that 1) MEMG and pharyngeal motor events may accompany TLESRs; and 2) esophageal contraction frequently heralds the onset, and it always occurs at completion of a TLESR.(ABSTRACT TRUNCATED AT 250 WORDS)

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.

Esophageal longitudinal muscle contraction: Another component of transient lower esophageal sphincter relaxation (tLESR)?

2001 ◽  
Vol 120 (5) ◽  
pp. A632
Author(s):  
Guoxiang Shi ◽  
John E. Pandolfino ◽  
Raymond J. Joehl ◽  
James G. Brassuer ◽  
Peter J. Kahrilas
Keyword(s):  
Muscle Contraction ◽  
Lower Esophageal Sphincter ◽  
Longitudinal Muscle ◽  
Lower Esophageal Sphincter Relaxation ◽  
Esophageal Sphincter

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.

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