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Related Experiment Videos

Upper esophageal sphincter function during antegrade and retrograde transit

P J Kahrilas1

  • 1Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA.

The American Journal of Medicine
|January 9, 1998
PubMed
Summary

The upper esophageal sphincter (UES) controls swallowing but doesn't prevent stomach reflux. Esophageal distension, especially with gas, increases reflux risk, highlighting UES dysfunction in gastroesophageal reflux disease (GERD).

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Area of Science:

  • Gastroenterology
  • Physiology
  • Swallowing Mechanics

Background:

  • The upper esophageal sphincter (UES) and surrounding structures form a unit controlling the esophageal inlet.
  • UES resting tone prevents air entry and proximal regurgitation.
  • Reflexes offer limited protection against stomach content regurgitation causing esophageal distension.

Purpose of the Study:

  • To investigate the protective reflexes of the UES against gastroesophageal reflux.
  • To understand the role of esophageal distension in UES function.
  • To explore factors influencing UES opening during swallowing.

Main Methods:

  • Analysis of UES function in relation to esophageal distension.
  • Observation of UES responses during spontaneous gastroesophageal reflux episodes.

Related Experiment Videos

  • Correlation of UES opening modulation with bolus properties and pharyngeal muscle activity.

    • Main Results:

    • UES reflexive responses do not significantly protect against stomach content-induced regurgitation.
    • Experimentally, esophageal distension can induce UES contraction, but this is not observed during spontaneous reflux.
    • Gaseous distension exacerbates reflux likelihood, particularly when combined with acid.
    • UES opening during swallowing is finely tuned by bolus characteristics and coordinated muscular activity, indicating sensory feedback.

    Conclusions:

    • The UES's protective mechanisms against gastroesophageal reflux are limited, especially during spontaneous events.
    • Esophageal distension, particularly gaseous, poses a significant risk for reflux events.
    • Swallowing involves complex sensory-motor integration for precise UES control, but this doesn't fully mitigate reflux challenges.