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Upper esophageal sphincter function during belching.

P J Kahrilas, W J Dodds, J Dent

    Gastroenterology
    |July 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

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    Belching involves upper esophageal sphincter (UES) relaxation, triggered by rapid esophageal distention, not the type of substance. This UES relaxation allows gas to escape the esophagus.

    Area of Science:

    • Gastroenterology
    • Physiology

    Background:

    • Belching is a common physiological process involving gas expulsion from the upper gastrointestinal tract.
    • The precise mechanism of upper esophageal sphincter (UES) involvement during belching remains incompletely understood.

    Purpose of the Study:

    • To elucidate the role of the upper esophageal sphincter (UES) in the mechanism of belching.
    • To investigate the stimuli that trigger UES relaxation during belching.

    Main Methods:

    • Studied 14 healthy volunteers using manometry to record esophageal pressures and sphincter activity.
    • Induce esophageal distention with air and fluid boluses, and proximal esophageal balloon distention.
    • Assessed the effect of mucosal anesthesia on UES responses.

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    Main Results:

    • Belching involves a sequence including lower esophageal sphincter relaxation, gastroesophageal gas reflux, UES relaxation, and esophagopharyngeal gas reflux.
    • Abrupt esophageal distention with air induced UES relaxation, similar to belching.
    • Esophageal distention with fluid did not induce UES relaxation; it either had no effect or increased UES pressure.
    • Mucosal anesthesia did not alter UES responses to gas or liquid boluses.
    • Rapid, spatially patterned distention of the proximal esophagus elicited UES relaxation.

    Conclusions:

    • The upper esophageal sphincter (UES) relaxes in response to rapid, spatially specific esophageal distention, facilitating belching.
    • The UES differentiates stimuli based on the pattern and speed of esophageal distention, not the type of substance (gas vs. liquid).
    • These findings clarify the physiological control of the UES during belching.