Effects of effortful swallow on esophageal function in healthy adults.

Abstract

BACKGROUND:

Treatment for esophageal dysmotility is currently limited to primarily pharmacologic intervention, which has questionable utility and frequently associated negative side effects. A potential behavioral intervention for esophageal dysmotility is the effortful oropharyngeal swallow. A previous pilot study using water perfusion manometry found an increase in distal esophageal amplitudes during effortful vs non-effortful swallowing. The current study sought to duplicate the previous study with improvements in methodology.

METHODS:

The effects of swallow condition (effortful vs non-effortful), sensor site, and gender on esophageal amplitude, duration, velocity, and bolus clearance were examined for 18 adults (nine males and nine females, mean age = 29.9 years) via combined solid-state manometry and intraluminal impedance.

KEY RESULTS:

The effortful swallow condition yielded significantly higher esophageal amplitudes across all sensor locations (P < 0.05). Further, the effortful swallowing decreased the risk of incomplete bolus clearance when compared with non-effortful swallowing (OR: 0.51; 95% CI: 0.30-0.86).

CONCLUSIONS & INFERENCES:

With improved manometric instrumentation, larger participant numbers, and methodology that controlled for potential confounding factors, this study confirms and advances the results of the previous pilot study: Volitional manipulation of the oropharyngeal phase of swallowing using the effortful swallow indeed affects esophageal physiology. Thus, the effortful swallow offers a behavioral manipulation of the esophageal phase of swallowing, and future studies will determine its clinical potential for treating esophageal dysmotility in patient populations.

• Authors: C G Nekl, C R Lintzenich, X Leng, T Lever, S G Butler
• Journal: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society (Neurogastroenterol Motil) Vol. 24 Issue 3 Pg. 252-6, e107-8 (Mar 2012) ISSN: 1365-2982 [Electronic] England
• PMID: 22316290 (Publication Type: Journal Article)
• Copyright: © 2012 Blackwell Publishing Ltd.

Topics

• Adult
• Deglutition (physiology)
• Electromyography (methods)
• Esophageal Motility Disorders (physiopathology, therapy)
• Esophagus (physiology, physiopathology)
• Female
• Humans
• Male
• Manometry (instrumentation, methods)
• Oropharynx (physiology, physiopathology)