Kahrilas P J, Dodds W J, Dent J, Wyman J B, Hogan W J, Arndorfer R C
Gastroenterology. 1986 Jul;91(1):133-40. doi: 10.1016/0016-5085(86)90449-x.
We studied the mechanism of belching with specific attention to the upper esophageal sphincter (UES) in 14 normal volunteers. Belching occurred by the following sequence of events: lower esophageal sphincter relaxation; gastroesophageal gas reflux, recorded manometrically as a gastroesophageal common cavity phenomenon; UES relaxation; esophagopharyngeal gas reflux; and restoration of intraesophageal pressure to baseline by a peristaltic contraction. Upper esophageal sphincter relaxations comparable to those associated with belches were induced by abrupt esophageal distention with air boluses. In contrast, fluid boluses injected into the midesophageal body either had no effect on UES pressure or increased UES pressure. Thus, the UES responded to esophageal body distention in two distinct ways: abrupt relaxation in response to air boluses and pressure augmentation in response to fluid boluses. Mucosal anesthesia did not alter the UES response to esophageal boluses of gas or liquid thereby making it unlikely that these substances are differentiated by a mucosal receptor. Rapid distention of the proximal esophagus with a cylindrical balloon (15 cm long) elicited UES relaxation. These findings suggest that the rapidity and spatial pattern of esophageal distention, rather than discrimination of the type of material causing the distention, determines whether or not UES relaxation occurs.
我们对14名正常志愿者进行了研究，特别关注上食管括约肌（UES）在嗳气过程中的机制。嗳气按以下事件顺序发生：食管下括约肌松弛；胃食管气体反流，通过测压记录为胃食管共同腔现象；UES松弛；食管咽气体反流；以及通过蠕动收缩使食管内压力恢复到基线水平。用空气团突然扩张食管可诱发与嗳气相关的UES松弛。相比之下，向食管中段注入液体团对UES压力要么没有影响，要么会增加UES压力。因此，UES对食管体部扩张有两种不同的反应方式：对空气团的突然松弛和对液体团的压力增加。黏膜麻醉并未改变UES对气体或液体食管团的反应，因此这些物质不太可能通过黏膜受体进行区分。用圆柱形气球（15厘米长）快速扩张食管近端可引起UES松弛。这些发现表明，食管扩张的速度和空间模式，而非引起扩张的物质类型的辨别，决定了UES是否会松弛。
