TY - JOUR
T1 - Distinct patterns of oesophageal shortening during primary peristalsis, secondary peristalsis and transient lower oesophageal sphincter relaxation
AU - Shi, G.
AU - Pandolfino, J. E.
AU - Joehl, R. J.
AU - Brasseur, J. G.
AU - Kahrilas, P. J.
PY - 2002
Y1 - 2002
N2 - This study characterized oesophageal shortening during secondary peristalsis and transient lower oesophageal sphincter relaxation (TLOSR) in an attempt to determine its contribution to the opening mechanism. Eight healthy subjects (four males, 26 ± 1 years) had metal clips affixed at 0, +3, and +8 cm relative to the squamocolumnar junction (SCJ), defining two distal oesophageal segments. Axial clip movement was assessed with concurrent videofluoroscopy and manometry during primary peristalsis, secondary peristalsis and TLOSR. Clip-defined oesophageal segment length change was measured at 0.5-s intervals. The magnitude of the most distal segment shortening was least with TLOSR, greatest with primary peristalsis and intermediate with secondary peristalsis. Conversely, maximal overall oesophageal shortening during TLOSR, evidenced by SCJ movement, was similar to that during primary peristalsis. In 3/12 TLOSRs, the moment of LOS opening and gas reflux was optimally imaged; SCJ excursion was 0.3 ± 0.1 cm prior to LOS opening and 1.4 ± 0.7 cm immediately after gas reflux. The segmental pattern of oesophageal shortening was distinct during primary peristalsis, secondary peristalsis and TLOSR. During TLOSR, significant elevation of the SCJ occurred only after LOS opening, suggesting that this was a consequence of oesophageal distension induced by gas reflux rather than a component of the opening mechanism.
AB - This study characterized oesophageal shortening during secondary peristalsis and transient lower oesophageal sphincter relaxation (TLOSR) in an attempt to determine its contribution to the opening mechanism. Eight healthy subjects (four males, 26 ± 1 years) had metal clips affixed at 0, +3, and +8 cm relative to the squamocolumnar junction (SCJ), defining two distal oesophageal segments. Axial clip movement was assessed with concurrent videofluoroscopy and manometry during primary peristalsis, secondary peristalsis and TLOSR. Clip-defined oesophageal segment length change was measured at 0.5-s intervals. The magnitude of the most distal segment shortening was least with TLOSR, greatest with primary peristalsis and intermediate with secondary peristalsis. Conversely, maximal overall oesophageal shortening during TLOSR, evidenced by SCJ movement, was similar to that during primary peristalsis. In 3/12 TLOSRs, the moment of LOS opening and gas reflux was optimally imaged; SCJ excursion was 0.3 ± 0.1 cm prior to LOS opening and 1.4 ± 0.7 cm immediately after gas reflux. The segmental pattern of oesophageal shortening was distinct during primary peristalsis, secondary peristalsis and TLOSR. During TLOSR, significant elevation of the SCJ occurred only after LOS opening, suggesting that this was a consequence of oesophageal distension induced by gas reflux rather than a component of the opening mechanism.
KW - Oesophageal shortening
KW - Primary peristalsis
KW - Reflux
KW - Secondary peristalsis
KW - Transient lower oesophageal sphincter relaxation
UR - http://www.scopus.com/inward/record.url?scp=0036402098&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036402098&partnerID=8YFLogxK
U2 - 10.1046/j.1365-2982.2002.00351.x
DO - 10.1046/j.1365-2982.2002.00351.x
M3 - Article
C2 - 12358678
AN - SCOPUS:0036402098
SN - 1350-1925
VL - 14
SP - 505
EP - 512
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 5
ER -