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Lower-esophageal sphincter function does not determine resting upper-esophageal sphincter pressure.
The American Journal of Digestive Diseases
|October 1, 1977
Summary
This study found no significant difference in upper-esophageal sphincter (UES) pressure related to lower-esophageal sphincter (LES) function or gastroesophageal reflux. Current manometric techniques do not support the theory of a stronger UES compensating for a weak LES.
Area of Science:
- Gastroenterology
- Esophageal Physiology
- Clinical Manometry
Background:
- The lower-esophageal sphincter (LES) and upper-esophageal sphincter (UES) play critical roles in preventing reflux and aspiration.
- A common hypothesis suggests that a weaker LES may be compensated by a stronger UES.
Purpose of the Study:
- To investigate the relationship between lower-esophageal sphincter (LES) pressure and upper-esophageal sphincter (UES) pressure.
- To determine if UES pressure differs in patients with varying degrees of LES dysfunction or gastroesophageal reflux disease (GERD).
Main Methods:
- Review of manometric data from 269 esophageal motility studies.
- Analysis of average and greatest UES pressures.
- Correlation with LES pressures and presence of gastroesophageal reflux (GER) via intraesophageal pH monitoring.
Main Results:
- No significant difference in average or greatest UES pressures was observed between patients with LES pressures below 10 mm Hg or above 20 mm Hg.
- UES pressures were similar in patients with and without confirmed gastroesophageal reflux.
- The data did not support a compensatory increase in UES pressure in individuals with low LES pressures.
Conclusions:
- Current manometric techniques do not provide evidence for the hypothesis that a stronger UES compensates for a weak LES and gastroesophageal reflux.
- The functional relationship between the UES and LES in the context of reflux remains unclear.
- Further research may be needed to explore alternative mechanisms or advanced diagnostic methods.