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Type: Journal article
Title: Distension of the esophagogastric junction augments triggering of transient lower esophageal sphincter relaxation
Author: van Wijk, M.
Blackshaw, L.
Dent, J.
Benninga, M.
Davidson, G.
Omari, T.
Citation: American Journal of Physiology: Gastrointestinal and Liver Physiology, 2011; 301(4):G713-G718
Publisher: Amer Physiological Soc
Issue Date: 2011
ISSN: 0193-1857
Statement of
Michiel P. van Wijk, L. Ashley Blackshaw, John Dent, Marc A. Benninga, Geoffrey P. Davidson, and Taher I. Omari
Abstract: Patients with gastroesophageal reflux disease show an increase in esophagogastric junction (EGJ) distensibility and in frequency of transient lower esophageal sphincter relaxations (TLESR) induced by gastric distension. The objective was to study the effect of localized EGJ distension on triggering of TLESR in healthy volunteers. An esophageal manometric catheter incorporating an 8-cm internal balloon adjacent to a sleeve sensor was developed to enable continuous recording of EGJ pressure during distension of the EGJ. Inflation of the balloon doubled the cross-section of the trans-sphincteric portion of the catheter from 5 mm OD (round) to 5 x 11 mm (oval). Ten healthy subjects were included. After catheter placement and a 30-min adaptation period, the EGJ was randomly distended or not, followed by a 45-min baseline recording. Subjects consumed a refluxogenic meal, and recordings were made for 3 h postprandially. A repeat study was performed on another day with EGJ distension status reversed. Additionally, in one subject MRI was performed to establish the exact position of the balloon in the inflated state. The number of TLESR increased during periods of EGJ distension with the effect being greater after a meal [baseline: 2.0(0.0–4.0) vs. 4.0(1.0–11.0), P=0.04; postprandial: 15.5(10.0–33.0) vs. 22.0(17.0–58.0), P=0.007 for undistended and distended, respectively]. EGJ distension augments meal-induced triggering of TLESR in healthy volunteers. Our data suggest the existence of a population of vagal afferents located at sites in/around the EGJ that may influence triggering of TLESR.
Keywords: Esophageal Sphincter, Lower
Esophagogastric Junction
Muscle Relaxation
Rights: Copyright © 2011 the American Physiological Society
DOI: 10.1152/ajpgi.00523.2010
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