Faculty Collaboration Database

Inhibition of progressing primary esophageal peristalsis by pharyngeal water stimulation in humans. Gastroenterology 1996 Feb;110(2):419-23

Date

02/01/1996

Pubmed ID

8566588

DOI

10.1053/gast.1996.v110.pm8566588

Scopus ID

2-s2.0-0030064592 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

BACKGROUND & AIMS: Sensory impulses initiated from the pharynx exert differing effects on the deglutitive apparatus. They have an inhibitory effect on the lower esophageal sphincter but an excitatory effect on the upper esophageal sphincter. The aim of this study was to systematically investigate the effect of pharyngeal sensory impulses evoked by water stimulation on the progressing esophageal peristalsis.

METHODS: Sixteen healthy young volunteers were studied in the supine position. The presence of normal peristalsis was verified. Esophageal peristalsis was recorded 3, 6, 9, 12, 15, and 18 cm above the lower esophageal sphincter. Pharyngeal stimulation was performed by injecting a predetermined threshold volume into the pharynx 2 cm above the upper esophageal sphincter, directed posteriorly. The injections were timed to coincide with the arrival of the peristaltic wave induced by dry swallows at respective recording sites.

RESULTS: Injection of the threshold volume (0.5 +/- 0.1 mL) stopped the progression of peristalsis at both the striated and smooth muscle esophagus. Topical pharyngeal anesthesia blocked this inhibitory effect (P < 0.01).

CONCLUSIONS: Sensory impulses initiated from the pharynx evoked by water injection inhibit the progression of primary esophageal peristalsis. Although the clinical significance of these findings is not determined, they may explain the mechanism of some of the failed esophageal peristalsis.

Author List

Trifan A, Ren J, Arndorfer R, Hofmann C, Bardan E, Shaker R

Author

Reza 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

Adult
Analysis of Variance
Anesthesia
Chi-Square Distribution
Esophagus
Evoked Potentials
Female
Humans
Male
Peristalsis
Pharynx
Sensation
Water