Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Neurogastroenterol Motil. 2023 Aug;35(8):e14608. doi: 10.1111/nmo.14608. Epub 2023 May 8.
BACKGROUND: Effect of inter-swallow interval on the contractility of smooth muscle esophagus is well-documented. However, the effects on peristalsis of the striated esophagus have not been systematically studied. A better understanding of striated esophagus motor function in health and disease may enhance the interpretation of manometric studies and inform clinical care. The aim of this study was to assess the effect of inter-swallow interval on striated esophagus compared to findings with that of the smooth muscle esophagus. METHODS: We performed two sets of studies to (1) determine the effect of various inter-swallow interval in 20 healthy volunteers and (2) assess the effect of ultra-short swallow intervals facilitated by straw drinking in 28 volunteers. We analyzed variables using ANOVA with Tukey's pairwise comparison and paired t-test. KEY RESULTS: Unlike smooth muscle esophagus, the striated esophagus contractile integral did not change significantly for swallow intervals ranging from 30 to 5 s. On the contrary, striated esophagus demonstrated absent or reduced peristalsis in response to ultra-short (<2 s) intervals during straw-facilitated multiple rapid swallows. CONCLUSIONS AND INFERENCES: Striated esophagus peristalsis is subject to manometrically observed inhibition during swallows with ultra-short intervals. Inter-swallow intervals as short as 5 s that inhibit smooth muscle esophagus peristalsis do not inhibit striated muscle peristalsis. The mechanisms of these observations are unknown but may relate to central or myenteric nervous system influences or the effects of pharyngeal biomechanics.
背景:吞咽间期对平滑肌食管收缩力的影响已有充分的文献记载。然而,其对横纹肌食管蠕动的影响尚未得到系统研究。更好地了解健康和疾病状态下横纹肌食管的运动功能,可能会增强对测压研究的解读,并为临床护理提供信息。本研究旨在评估与平滑肌食管相比,吞咽间期对横纹肌食管的影响。
方法:我们进行了两组研究,(1)确定 20 名健康志愿者在不同吞咽间期下的影响,(2)评估 28 名志愿者通过吸管饮水促进超短吞咽间期的影响。我们使用方差分析(ANOVA)和 Tukey 配对比较以及配对 t 检验来分析变量。
主要结果:与平滑肌食管不同,吞咽间期在 30 至 5 秒范围内时,横纹肌食管的收缩积分没有明显变化。相反,在吸管促进多次快速吞咽时,超短(<2 秒)间期会导致横纹肌食管蠕动消失或减弱。
结论和推论:在超短吞咽间期时,横纹肌食管蠕动受到测压观察到的抑制。抑制平滑肌食管蠕动的间隔短至 5 秒并不会抑制横纹肌蠕动。这些观察结果的机制尚不清楚,但可能与中枢或肌间神经的影响或咽腔生物力学的影响有关。
Neurogastroenterol Motil. 2023-8
Gastroenterology. 1987-3
Dysphagia. 1993
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Gastroenterol Clin North Am. 1989-6
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