scholarly journals Systematic Review of Pharyngeal and Esophageal Manometry in Healthy or Dysphagic Older Persons (>60 years)

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 67 ◽  
Author(s):  
Charles Cock ◽  
Taher Omari
Keyword(s):  
Systematic Review ◽  
Clinical Studies ◽  
Esophageal Manometry ◽  
Flow Resistance ◽  
Young Patients ◽  
Upper Esophageal Sphincter ◽  
Noncardiac Chest Pain ◽  
Older Individuals ◽  
Show Evidence ◽  
Esophageal Sphincter

We undertook a systematic review of swallowing biomechanics, as assessed using pharyngeal and esophageal manometry in healthy or dysphagic older individuals aged over 60 years of age, comparing findings to studies of younger participants. PRISMA-P methodology was used to identify, select, and evaluate eligible studies. Across studies, older participants had lower upper esophageal sphincter (UES) resting pressures and evidence of decreased UES relaxation when compared to younger groups. Intrabolus pressures (IBP) above the UES were increased, demonstrating flow resistance at the UES. Pharyngeal contractility was increased and prolonged in some studies, which may be considered as an attempt to compensate for UES flow resistance. Esophageal studies show evidence of reduced contractile amplitudes in the distal esophagus, and an increased frequency of failed peristaltic events, in concert with reduced lower esophageal sphincter relaxation, in the oldest subjects. Major motility disorders occurred in similar proportions in older and young patients in most clinical studies, but some studies show increases in achalasia or spastic motility in older dysphagia and noncardiac chest pain patients. Overall, study qualities were moderate with a low likelihood of bias. There were few clinical studies specifically focused on swallowing outcomes in older patient groups and more such studies are needed.

Esophageal manometry in the opossum.

1977 ◽  
Vol 233 (3) ◽  
pp. E152
Author(s):  
K Schulze ◽  
W J Dodds ◽  
J Christensen ◽  
J D Wood
Keyword(s):  
Animal Model ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Lower Esophageal Sphincter Pressure ◽  
Upper Esophageal Sphincter ◽  
Sphincter Pressure ◽  
Coronal Section ◽  
Esophageal Sphincter ◽  
Human Esophagus

The opossum esophagus is commonly used as an animal model of the human esophagus. We used esophageal manometry in normal animals to provide basal data about normal esophageal motor functions in vivo in this species. At rest, separate and distinct high pressure zones can be recorded at the level of the lower esophageal sphincter, diaphragmatic hiatus, aortic arch, and upper esophageal sphincter. Each zone demonstrates a characteristic pattern of pressures in the radii of the coronal section and a characteristic response to swallowing. The hiatal and aortic zones can be mistaken for the esophageal sphincters. Pressures in the sphincters fall with swallowing. Peristalsis is not bolus-dependent and occurs with 98% of swallows. Pressures generated by peristalsis are greater in the middle of the esophagus than at the ends. Values for resting lower esophageal sphincter pressure and the characteristics of peristalsis were reproducible between different studies in the same animals.

scholarly journals Esophageal Peristalsis Disorders in ALS Patients with Dysphagia

2020 ◽  
Vol 10 (11) ◽  
pp. 820
Author(s):  
Jerzy Tomik ◽  
Klaudia Sowula ◽  
Mateusz Dworak ◽  
Kamila Stolcman ◽  
Małgorzata Maraj ◽  
...  
Keyword(s):  
Esophageal Manometry ◽  
Clinical Presentation ◽  
Upper Esophageal Sphincter ◽  
Esophageal Peristalsis ◽  
Resting Pressure ◽  
Esophageal Sphincter ◽  
Risk Of Aspiration ◽  
Als Patients ◽  
Low Amplitude ◽  
Lateral Sclerosis

To detect the variations of esophageal peristalsis in amyotrophic lateral sclerosis (ALS) patients with predominantly bulbar or predominantly pseudobulbar clinical presentation by using esophageal manometry (EM). Fifteen ALS patients with pseudobulbar clinical presentation (PBP) and 13 patients with bulbar presentation (BP), fulfilling WFN Criteria, were studied. EM was performed in all subjects using a flexible catheter with solid-state transducers. Swallowing was initiated with 5 to 10 mL of water (wet swallows) and saliva (dry swallows) and repeated at 30 s intervals. The manometric parameters were measured automatically and visualized by the computer system. The tracings were analyzed using Synectics software. In PBP patients, an increase of resting pressure value in the upper esophageal sphincter (UES) >45 mmHg, a wave-like course of resting pressure, and toothed peristaltic waves were observed. In BP patients, a low amplitude of peristaltic waves <30 mmHg (mean: 17 ± 5) was recorded, without signs of esophageal motility disturbance at onset or during progression. EM procedure allows objectively distinguishing dysphagia in ALS patients due to bulbar syndrome from the dysphagia due to pseudobulbar syndrome. It is important to identify PBP patients because of their high risk of aspiration.

scholarly journals Upper esophageal sphincter resting pressure varies during esophageal manometry

2014 ◽  
Vol 27 (3) ◽  
pp. 182-183 ◽  
Author(s):  
Daniel Tavares REZENDE ◽  
Fernando A. M. HERBELLA ◽  
Luciana C. SILVA ◽  
Sebastião PANOCCHIA-NETO ◽  
Marco G. PATTI
Keyword(s):  
High Resolution ◽  
Esophageal Manometry ◽  
Striated Muscle ◽  
Upper Esophageal Sphincter ◽  
Standard Test ◽  
Sphincter Pressure ◽  
High Resolution Manometry ◽  
Basal Pressure ◽  
Resting Pressure ◽  
Esophageal Sphincter

BACKGROUND: The upper esophageal sphincter is composed of striated muscle. The stress of intubation and the need to inhibit dry swallows during an esophageal manometry test may lead to variations in basal pressure of this sphincter. Upper esophageal sphincter is usually only studied at the final part of the test. Was observed during the performance of high resolution manometry that sphincter pressure may vary significantly over the course of the test. AIM: To evaluate the variation of the resting pressure of the upper esophageal sphincter during high resolution manometry. METHODS: Was evaluated the variation of the basal pressure of the upper esophageal sphincter during high resolution manometry. Were reviewed the high resolution manometry tests of 36 healthy volunteers (mean age 31 years, 55% females). The basal pressure of the upper esophageal sphincter was measured at the beginning and at the end of a standard test. RESULTS: The mean time of the test was eight minutes. The basal pressure of the upper esophageal sphincter was 100 mmHg at the beginning of the test and 70 mmHg at the end (p<0.001). At the beginning, one patient had hypotonic upper esophageal sphincter and 14 hypertonic. At the end of the test, one patient had hypotonic upper esophageal sphincter (same patient as the beginning) and seven hypertonic upper esophageal sphincter. CONCLUSION: A significant variation of the basal pressure of the upper esophageal sphincter was observed in the course of high resolution manometry. Probably, the value obtained at the end of the test may be more clinically relevant.

scholarly journals A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults With Normal and Disordered Swallowing

2020 ◽  
Vol 29 (3) ◽  
pp. 1655-1673
Author(s):  
Mariana M. Bahia ◽  
Soren Y. Lowell
Keyword(s):  
Systematic Review ◽  
Upper Esophageal Sphincter ◽  
Future Research ◽  
Eligibility Criteria ◽  
Swallowing Function ◽  
Effortful Swallow ◽  
Medium Quality ◽  
Esophageal Sphincter ◽  
Meta Analyses

Purpose This systematic review summarizes the biomechanical and functional effects of the effortful swallow in adults with and without dysphagia, highlighting clinical implications and future research needs. Specifically, the effects of the effortful swallow on swallowing physiology, safety, and efficiency were identified, as well as the strengths and limitations of current research. Method Recommendations specified by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. A literature search of three databases and relevant articles cited in the searched studies was performed. Two evaluators independently analyzed the studies for eligibility criteria, and final inclusion of studies was decided by consensus. Evaluators also assessed each study for quality of evidence. Results Twenty-three studies were included in this systematic review. Main findings indicated that the effortful swallow generated greater pressures in the tongue-to-palate, pharynx, upper esophageal sphincter, and esophageal regions. Inconsistent results for hyolaryngeal excursion were reported, as well as for swallowing function. Instructions of the effortful swallow varied greatly across studies. Two of the 23 studies were judged to be of high quality, and the remaining studies were of medium quality based on the quality indicators of this review. Conclusions Biomechanical effects of the effortful swallow included increased pressures in the oral, pharyngeal, and esophageal regions. Future investigations should address the effects of the effortful swallow in individuals with dysphagia and its potential role as a rehabilitative maneuver. Moreover, standardization of the effortful swallow instructions based on its physiological and functional effects is essential.

scholarly journals Upper esophageal sphincter abnormalities on high-resolution esophageal manometry and treatment response of type II achalasia

2020 ◽  
Vol 8 (4) ◽  
pp. 723-735
Author(s):  
Can-Ze Huang ◽  
Zai-Wei Huang ◽  
Hua-Min Liang ◽  
Zhen-Jiang Wang ◽  
Ting-Ting Guo ◽  
...  
Keyword(s):  
High Resolution ◽  
Treatment Response ◽  
Esophageal Manometry ◽  
Upper Esophageal Sphincter ◽  
Type Ii ◽  
Esophageal Sphincter
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