Lower esophageal sphincter relaxation is impaired in older patients with dysphagia

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dc.contributor.authorBesanko, L.
dc.contributor.authorBurgstad, C.
dc.contributor.authorMountifield, R.
dc.contributor.authorAndrews, J.
dc.contributor.authorHeddle, R.
dc.contributor.authorChecklin, H.
dc.contributor.authorFraser, R.
dc.date.issued2011
dc.description.abstractAIM: To characterize the effects of age on the mechanisms underlying the common condition of esophageal dysphagia in older patients, using detailed manometric analysis. METHODS: A retrospective case-control audit was performed on 19 patients aged ≥ 80 years (mean age 85 ± 0.7 year) who underwent a manometric study for dysphagia (2004-2009). Data were compared with 19 younger dysphagic patients (32 ± 1.7 years). Detailed manometric analysis performed prospectively included basal lower esophageal sphincter pressure (BLESP), pre-swallow and nadir LESP, esophageal body pressures and peristaltic duration, during water swallows (5 mL) in right lateral (RL) and upright (UR) postures and with solids. Data are mean ± SE; a P-value < 0.05 was considered significant. RESULTS: Elderly dysphagic patients had higher BLESP than younger patients (23.4 ± 3.8 vs 14.9 ± 1.2 mmHg; P < 0.05). Pre-swallow LESP was elevated in the elderly in both postures (RL: 1 and 4 s P = 0.019 and P = 0.05; UR: P < 0.05 and P = 0.05) and solids (P < 0.01). In older patients, LES nadir pressure was higher with liquids (RL: 2.3 ± 0.6 mmHg vs 0.7 ± 0.6 mmHg, P < 0.05; UR: 3.5 ± 0.9 mmHg vs 1.6 ± 0.5 mmHg, P = 0.01) with shorter relaxation after solids (7.9 ± 1.5 s vs 9.7 ± 0.4 s, P = 0.05). No age-related differences were seen in esophageal body pressures or peristalsis duration. CONCLUSION: Basal LES pressure is elevated and swallow-induced relaxation impaired in elderly dysphagic patients. Its contribution to dysphagia and the effects of healthy ageing require further investigation.
dc.description.statementofresponsibilityLaura K Besanko, Carly M Burgstad, Reme Mountifield, Jane M Andrews, Richard Heddle, Helen Checklin, Robert JL Fraser
dc.identifier.citationWorld Journal of Gastroenterology, 2011; 17(10):1326-1331
dc.identifier.doi10.3748/wjg.v17.i10.1326
dc.identifier.issn1007-9327
dc.identifier.issn2219-2840
dc.identifier.orcidAndrews, J. [0000-0001-7960-2650]
dc.identifier.urihttp://hdl.handle.net/2440/66970
dc.language.isoen
dc.publisherW J G Press
dc.rightsCopyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
dc.source.urihttps://doi.org/10.3748/wjg.v17.i10.1326
dc.subjectDysphagia
dc.subjectElderly
dc.subjectEsophageal Motility
dc.subjectLower Esophageal Sphincter
dc.subjectAging
dc.titleLower esophageal sphincter relaxation is impaired in older patients with dysphagia
dc.typeJournal article
pubs.publication-statusPublished

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