Impaired upper esophageal sphincter reflexes in patients with supraesophageal reflux disease. Gastroenterology 2015 Nov;149(6):1381-91
Date
07/21/2015Pubmed ID
26188682Pubmed Central ID
PMC4628603DOI
10.1053/j.gastro.2015.07.007Scopus ID
2-s2.0-84945570320 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
BACKGROUND & AIMS: Normal responses of the upper esophageal sphincter (UES) and esophageal body to liquid reflux events prevent esophagopharyngeal reflux and its complications, however, abnormal responses have not been characterized. We investigated whether patients with supraesophageal reflux disease (SERD) have impaired UES and esophageal body responses to simulated reflux events.
METHODS: We performed a prospective study of 25 patients with SERD (age, 19-82 y; 13 women) and complaints of regurgitation and supraesophageal manifestations of reflux. We also included 10 patients with gastroesophageal reflux disease (GERD; age, 32-60 y; 7 women) without troublesome regurgitation and supraesophageal symptoms and 24 healthy asymptomatic individuals (controls: age, 19-49 y; 13 women). UES and esophageal body pressure responses, along with luminal distribution of infusate during esophageal rapid and slow infusion of air or liquid, were monitored by concurrent high-resolution manometry and intraluminal impedance.
RESULTS: A significantly smaller proportion of patients with SERD had UES contractile reflexes in response to slow esophageal infusion of acid than controls or patients with GERD. Only patients with SERD had abnormal UES relaxation responses to rapid distension with saline. Diminished esophageal peristaltic contractions resulted in esophageal stasis in patients with GERD or SERD.
CONCLUSIONS: Patients with SERD and complaints of regurgitation have impaired UES and esophageal responses to simulated liquid reflux events. These patterns could predispose them to esophagopharyngeal reflux.
Author List
Babaei A, Venu M, Naini SR, Gonzaga J, Lang IM, Massey BT, Jadcherla S, Shaker RAuthors
Ivan M. Lang DVM, PhD Adjunct Professor in the Medicine department at Medical College of WisconsinBenson 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
AdultAged
Aged, 80 and over
Air
Electric Impedance
Esophageal Sphincter, Upper
Female
Gastroesophageal Reflux
Humans
Laryngopharyngeal Reflux
Male
Manometry
Middle Aged
Muscle Contraction
Peristalsis
Prospective Studies
Reflex
Water
Young Adult
