Determinants of lower esophageal sphincter relaxation induced by
esophageal balloon distension in man.
Manthey, Mitchell W., Benson T. Massey, Ronald C. Arndorfer, Walter J.
Hogan.
Medical College of Wisconsin Dysphagia Institute and the Department
of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
APStracts 3:0010G, 1996.
The determinants of the lower esophageal sphincter relaxation response
to esophageal distension have not previously been systematically
examined in man. In this study 14 healthy subjects were tested using
a manometry catheter with a sleeve device and 3 balloons spaced 5 cm
apart. Subjects had up to five distensions with each balloon at four
different diameters and two different durations of inflation.
Results: 1170?separate distensions were available for analysis.
Sphincter relaxation occurred more frequently (P < 0.005) with
larger balloon diameters, yet occurred in only 84% of inflations at
the largest diameter. Sphincter relaxation was more often observed
with the proximal balloon (P<.005), during longer distensions (P
< 0.05), and when esophageal contractions occurred above the
balloon (P < 0.005). Once sphincter relaxation occurred, its
magnitude was essentially independent of balloon site and diameter,
distension duration, and the presence of proximal contractions.
Conclusions: Even large balloon distensions do not uniformly produce
or maintain lower esophageal sphincter relaxation. Sphincter
relaxation is more likely with proximal esophageal distension. The
association of sphincter relaxation with vagally mediated proximal
contractions suggests vagal modulation of this response.
Received 10 April 1995; accepted in final form 18 November 1995.
APS Manuscript Number G148-5.
Article publication pending Am. J. Physiol. (Gastrointest. Liver
Physiology).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 22 January 96