Effect of pharyngeal water stimulation on esophageal peristalsis
and bolus transport.
Bardan, Eytan, Pengyan Xie, Junlong Ren, Kulwinder Dua, Reza Shaker.
MCW Dysphagia Institute, the Departments of Medicine, Radiology and
Otolaryngology and Human Communications, The Medical College of
Wisconsin, and VA Medical Center, Milwaukee, WI. Chaim Sheba Medical
Center, Department of Gastroenterology, University of Tel Aviv, Tel
-Hashomer, Israel
APStracts 3:0199G, 1996.
Background: Sensory stimuli originated from the pharynx inhibits
esophageal peristalsis induced by a dry swallow. Our aims were to
determine the effect of these stimuli on esophageal bolus transport
and esophageal peristalsis induced by swallowing different volumes of
liquid and semi-solid boluses. Methods: We studied 9 healthy
volunteers age 35+/-4 yrs in supine position by intraluminal
esophageal manometry as well as concurrent videofluoroscopy and
manometry. Results: In all subjects progression of peristalsis
induced by swallowing of different volumes of water and mashed potato
boluses was inhibited at all sites by pharyngeal water injection.
Threshold volume for inhibition of the peristalsis induced by
swallows of 5 and 10 mL of water was similar but significantly higher
compared to dry swallows (P < 0.05). Pharyngeal water
injection invariably halted transit of the barium boluses through the
esophagus. Conclusion: Sensory impulses originated from the pharynx:
a) inhibits esophageal bolus transit; and b) is capable of overcoming
the facilitating effect of a liquid bolus on the swallowing
apparatus. This phenomenon may explain the mechanism of some of the
failed esophageal peristalsis observed in clinical practice.
Received 8 May 1996; accepted in final form 9 September 1996.
APS Manuscript Number G188-6.
Article publication pending Am. J. Physiol. (Gastrointest. Liver
Physiology).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 7 October 1996