Faculty Collaboration Database

Effect of lower esophageal sphincter tone and crural diaphragm contraction on distensibility of the gastroesophageal junction in humans. Am J Physiol Gastrointest Liver Physiol 2004 Oct;287(4):G815-21

Date

09/14/2004

Pubmed ID

15361362

DOI

10.1152/ajpgi.00120.2004

Scopus ID

2-s2.0-4644346436 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

Previous studies of distensibility of the gastroesophageal junction (GEJ) in humans have not tried to distinguish between the effects of muscle action and passive elastic tissue properties of the GEJ. We studied 15 healthy subjects (ages 23-67 yr, 11 men/4 women) by using a catheter with a highly complaint bag positioned manometrically at the GEJ. The bag was distended with air at a rate of 20 ml/min while intrabag pressure was recorded. Distensions were performed during normal breathing, with breath held at maximum inspiration (MI) to activate the diaphragmatic crura, and with midesophageal balloon distension (BD) to relax the lower esophageal sphincter. In 10 subjects, distensions were performed after atropine injection (12 microg/kg iv). Pressure-volume curves and incremental distensibility values were calculated and compared among the different conditions. Both MI and BD significantly altered the slopes of the pressure-volume curves, whereas no effect was seen with atropine. Maximum distensibility was seen at the volume increment of 5-10 ml and was reduced with larger volumes. Distensibility measurements for the various test conditions tended to converge at the largest volume increment, suggesting that distensibility at this degree of distension was more related to the passive elastic properties of the GEJ. On the basis of these findings, we conclude that there can be significant active muscular contributions to recordings of distensibility at the GEJ, variations that must be controlled for during different study conditions.

Author List

Shaker R, Bardan E, Gu C, Massey BT, Sanders T, Kern MK, Hoffmann RG, Hogan WJ

Authors

Mark K. Kern Research Scientist II in the Medicine department at Medical College of Wisconsin
Benson T. Massey MD Professor in the Medicine department at Medical College of Wisconsin
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
Aged
Atropine
Catheterization
Diaphragm
Esophagogastric Junction
Female
Fluoroscopy
Humans
Inhalation
Male
Manometry
Middle Aged
Muscle Contraction
Muscle Relaxation
Parasympatholytics
Pressure