Skip to main content
PMC home page
Gut logoLink to Gut
. 1993 Jul;34(7):904–910. doi: 10.1136/gut.34.7.904

Effect of gastro-oesophageal reflux on upper oesophageal sphincter motility in children.

J Willing 1, G P Davidson 1, J Dent 1, I Cook 1
PMCID: PMC1374223  PMID: 8344577

Abstract

Motor events of the upper oesophageal sphincter associated with gastro-oesophageal reflux were evaluated in 53 symptomatic children (median age 13 months) who were studied recumbent and unsedated. Children were divided into four groups according to symptoms, and then into two groups according to the presence or absence of neurological deficit. No grouping had basal upper oesophageal sphincter pressure that differed significantly from any other. Oesophageal distention due to gastro-oesophageal reflux, which was recognisable as oesophageal common cavity episodes, was associated with augmentation of mean basal upper oesophageal sphincter pressure from 36.5 (SD 18) mm Hg to 48.5 (18) mm Hg (p < 0.0001), irrespective of whether gastro-oesophageal reflux caused oesophageal acidification. Abrupt relaxations of the upper oesophageal sphincter independent of swallowing and lasting up to three seconds occurred during 54% of common cavity episodes. Forty nine per cent of these relaxations occurred within four seconds after the onset of distention. The oesophageal distention caused by gastro-oesophageal reflux is a potent stimulus of transient upper oesophageal sphincter relaxations in children. These relaxations are a more likely explanation for oesophagopharyngeal reflux than defective basal upper oesophageal sphincter tone.

Full text

PDF
907

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Davidson G. P., Dent J., Willing J. Monitoring of upper oesophageal sphincter pressure in children. Gut. 1991 Jun;32(6):607–611. doi: 10.1136/gut.32.6.607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dent J., Dodds W. J., Friedman R. H., Sekiguchi T., Hogan W. J., Arndorfer R. C., Petrie D. J. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects. J Clin Invest. 1980 Feb;65(2):256–267. doi: 10.1172/JCI109667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Frankenburg W. K., Dodds J. B. The Denver developmental screening test. J Pediatr. 1967 Aug;71(2):181–191. doi: 10.1016/s0022-3476(67)80070-2. [DOI] [PubMed] [Google Scholar]
  4. Gerhardt D. C., Castell D. O., Winship D. H., Shuck T. J. Esophageal dysfunction in esophagopharyngeal regurgitation. Gastroenterology. 1980 May;78(5 Pt 1):893–897. [PubMed] [Google Scholar]
  5. Gerhardt D. C., Shuck T. J., Bordeaux R. A., Winship D. H. Human upper esophageal sphincter. Response to volume, osmotic, and acid stimuli. Gastroenterology. 1978 Aug;75(2):268–274. [PubMed] [Google Scholar]
  6. Kahrilas P. J., Dent J., Dodds W. J., Hogan W. J., Arndorfer R. C. A method for continuous monitoring of upper esophageal sphincter pressure. Dig Dis Sci. 1987 Feb;32(2):121–128. doi: 10.1007/BF01297099. [DOI] [PubMed] [Google Scholar]
  7. Kahrilas P. J., Dodds W. J., Dent J., Haeberle B., Hogan W. J., Arndorfer R. C. Effect of sleep, spontaneous gastroesophageal reflux, and a meal on upper esophageal sphincter pressure in normal human volunteers. Gastroenterology. 1987 Feb;92(2):466–471. doi: 10.1016/0016-5085(87)90143-0. [DOI] [PubMed] [Google Scholar]
  8. Kahrilas P. J., Dodds W. J., Dent J., Wyman J. B., Hogan W. J., Arndorfer R. C. Upper esophageal sphincter function during belching. Gastroenterology. 1986 Jul;91(1):133–140. doi: 10.1016/0016-5085(86)90449-x. [DOI] [PubMed] [Google Scholar]
  9. MCNALLY E. F., KELLY J. E., Jr, INGELFINGER F. J. MECHANISM OF BELCHING: EFFECTS OF GASTRIC DISTENSION WITH AIR. Gastroenterology. 1964 Mar;46:254–259. [PubMed] [Google Scholar]
  10. Sondheimer J. M. Upper esophageal sphincter and pharyngoesophageal motor function in infants with and without gastroesophageal reflux. Gastroenterology. 1983 Aug;85(2):301–305. [PubMed] [Google Scholar]
  11. Staiano A., Cucchiara S., De Vizia B., Andreotti M. R., Auricchio S. Disorders of upper esophageal sphincter motility in children. J Pediatr Gastroenterol Nutr. 1987 Nov-Dec;6(6):892–898. doi: 10.1097/00005176-198711000-00012. [DOI] [PubMed] [Google Scholar]
  12. Vakil N. B., Kahrilas P. J., Dodds W. J., Vanagunas A. Absence of an upper esophageal sphincter response to acid reflux. Am J Gastroenterol. 1989 Jun;84(6):606–610. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES