Terminating motor events for TLESR are influenced by the presence and distribution of refluxate. Am J Physiol Gastrointest Liver Physiol 2009 Jul;297(1):G71-5
Date
05/23/2009Pubmed ID
19460846Pubmed Central ID
PMC3817257DOI
10.1152/ajpgi.00017.2009Scopus ID
2-s2.0-67650066782 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
Transient lower esophageal sphincter relaxation (TLESR) is frequently associated with reflux events and terminates with a primary or secondary peristaltic wave. However, it is unclear whether the presence and properties of the refluxate affect TLESR-termination events. The aims of this study were to determine the pattern of terminating esophageal motor activity after TLESR in healthy subjects and factors affecting the type of terminating motor event. Fifteen healthy subjects (7 men, age 18-56) were studied. High-resolution manometry and impedance/pH monitoring were performed simultaneously in supine position for 2 h after subjects took a 1,000-kcal meal (Awake Study). This procedure was repeated during the night under polysomnographic recording for 6-8 h after consuming a 1,000-kcal meal (Sleep Study). We categorized three types of TLESR-terminating motor events, primary peristalsis (PP), full secondary contraction (FSC), which propagated the entire esophagus, and partial secondary contractions (PSC), which started distal to the upper esophageal sphincter. Overall, 289 TLESR events were found. The percentages of TLESR events terminated by PP, FSC, and PSC were 22%, 14%, and 64%, respectively. TLESR events terminated by PP were less likely to be accompanied by reflux events. TLESR events terminated by FSC were significantly more likely to have evidence for proximal esophageal reflux and esophago-pharyngeal reflux. Findings were similar in awake and sleep states. We concluded that, in healthy recumbent subjects, the most common TLESR-termination event is a secondary contraction, rather than PP. Presence and distribution of the refluxate is a major influence on the type of terminating contraction.
Author List
Kuribayashi S, Massey BT, Hafeezullah M, Perera L, Hussaini SQ, Tatro L, Darling RJ, Franco R, Shaker RAuthors
Benson T. Massey MD Professor in the Medicine department at Medical College of WisconsinReza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Carbonated Beverages
Consciousness
Eating
Esophageal Sphincter, Lower
Esophageal pH Monitoring
Esophagoscopy
Female
Gastroesophageal Reflux
Humans
Male
Manometry
Middle Aged
Muscle Contraction
Muscle Relaxation
Peristalsis
Polysomnography
Postprandial Period
Pressure
Sleep
Supine Position
Time Factors
Young Adult
