Effect of medium- and long-chain triglycerides on lower esophageal sphincter pressure: role of CCK

1998 ◽  
Vol 274 (6) ◽  
pp. G1160-G1165
Author(s):  
M. Ledeboer ◽  
A. A. M. Masclee ◽  
I. Biemond ◽  
C. B. H. W. Lamers

Fat meals are known to decrease lower esophageal sphincter (LES) pressure, possibly through postprandial CCK release. Dietary fat consists mainly of long-chain triglycerides (LCT), which potently stimulate CCK secretion. This effect contrasts with that of medium-chain triglycerides (MCT), which do not induce CCK release. We recorded LES pressure and gallbladder volume in six healthy subjects on five separate occasions during intraduodenal administration of 1) saline control, 2) LCT, 3) MCT, 4) LCT during intravenous infusion of the CCK receptor antagonist loxiglumide, and 5) MCT together with loxiglumide. LES pressure decreased significantly during administration of both LCT and MCT. Loxiglumide completely prevented the reduction in LES pressure during intraduodenal LCT, but not during intraduodenal MCT. Gallbladder volume decreased during LCT, but not during MCT. It is concluded that intraduodenal administration of equimolar amounts of both LCT and MCT significantly reduces LES pressure. The effect of LCT on LES pressure is mediated by CCK. The effect of MCT is not dependent on CCK, since MCT does not release CCK and loxiglumide does not prevent the MCT-induced reduction in LES pressure.

2021 ◽  
Vol 10 (1) ◽  
pp. 8-13
Author(s):  
Shankar Baral ◽  
Bidhan NIdhi Paudel ◽  
Ajit Khanal ◽  
Jiwan Thapa ◽  
Bhuwneshwer Yadhav ◽  
...  

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.  


1978 ◽  
Vol 75 (2) ◽  
pp. 283-285 ◽  
Author(s):  
H.R. Koelz ◽  
G. Lepsien ◽  
A.P. Hollinger ◽  
H. Säuberli ◽  
F. Largiadér ◽  
...  

1977 ◽  
Vol 233 (3) ◽  
pp. E152
Author(s):  
K Schulze ◽  
W J Dodds ◽  
J Christensen ◽  
J D Wood

The opossum esophagus is commonly used as an animal model of the human esophagus. We used esophageal manometry in normal animals to provide basal data about normal esophageal motor functions in vivo in this species. At rest, separate and distinct high pressure zones can be recorded at the level of the lower esophageal sphincter, diaphragmatic hiatus, aortic arch, and upper esophageal sphincter. Each zone demonstrates a characteristic pattern of pressures in the radii of the coronal section and a characteristic response to swallowing. The hiatal and aortic zones can be mistaken for the esophageal sphincters. Pressures in the sphincters fall with swallowing. Peristalsis is not bolus-dependent and occurs with 98% of swallows. Pressures generated by peristalsis are greater in the middle of the esophagus than at the ends. Values for resting lower esophageal sphincter pressure and the characteristics of peristalsis were reproducible between different studies in the same animals.


1980 ◽  
Vol 238 (1) ◽  
pp. G40-G44
Author(s):  
R. K. Goyal ◽  
S. Rattan

Infusions of verapamil (V) and sodium nitroprusside (NP) caused dose-dependent reductions in the lower esophageal sphincter pressure (LESP) in anesthetized opossums. Verapamil caused a gradual fall during the infusion and a gradual recovery upon cessation of the infusion. On the other hand, NP caused a prompt reduction and a prompt recovery. Both the agents also caused a fall in arterial blood pressure, but the fall in LESP was not related to the fall in the blood pressure. Both the agents antagonized the tonic and the phasic components of the LESP and, in large doses, both drugs almost abolished the LESP. Esophageal contractions were also antagonized by both agents, although verapamil was more effective than nitroprusside in this regard. These studies show that phasic and tonic components of LESP are not related to distinctive verapamil and nitroprusside sensitive calcium activation systems. Moreover, the V- and NP-sensitive calcium activation systems may lie in series rather than parallel.


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