Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation

Philippe Pouderoux*, Eric Verdier, Peter J. Kahrilas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Lower esophageal sphincter (LES) relaxation and esophageal body inhibition co-occur during esophageal peristalsis but not necessarily during pharyngeal stimulation or transient LES relaxation (tLESR). This study examined these relationships and the impact on reflux. Nine young volunteers were studied. An artificial high-pressure zone (HPZ) was established, and pH was recorded 8 and 5 cm proximal to the LES. Pharyngeal stimulation was by water injection and gastric distension with liquid or gas. Peristalsis, pharyngeal stimulation, and spontaneous events were recorded. Swallowing relaxed the LES in 100% of trials (the HPZ in 80%) and caused no reflux. Pharyngeal stimulation relaxed the LES in two-thirds of trials, had no effect on the HPZ, and caused no reflux. Gastric distension was associated with 117 tLESRs, 48% with acid reflux, and 32% with gas reflux; there was no effect on the HPZ. We conclude that LES relaxation is a necessary but not sufficient condition for reflux. LES relaxation and esophageal body inhibition are independent events that may be concurrent (swallowing) or dissociated (tLESR).

Original languageEnglish (US)
Pages (from-to)G242-G247
JournalAmerican Journal of Physiology - Gastrointestinal and Liver Physiology
Volume284
Issue number2 47-2
DOIs
StatePublished - Feb 1 2003

Keywords

  • Esophageal primary peristalsis
  • Gastroesophageal reflux
  • Pharynx
  • Swallow
  • Transient LES relaxation

ASJC Scopus subject areas

  • Physiology
  • Hepatology
  • Gastroenterology
  • Physiology (medical)

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