Skip to main content
NCBI home page
Gut logoLink to Gut
. 1990 Jun;31(6):639–646. doi: 10.1136/gut.31.6.639

Control of belching by the lower oesophageal sphincter.

J B Wyman 1, J Dent 1, R Heddle 1, W J Dodds 1, J Toouli 1, J Downton 1
PMCID: PMC1378487  PMID: 2379867

Abstract

The mechanism that controls venting of gas from the stomach into the oesophagus was studied manometrically in 14 healthy subjects. The stomach was distended abruptly with one litre of carbon dioxide. Gas reflux was characterised by an abrupt increase in basal oesophageal body pressure to intragastric pressure. Reflux of gas from the stomach into the oesophagus occurred during transient lower oesophageal sphincter relaxations that generally had a pattern distinctly different from swallow-induced lower oesophageal sphincter relaxation. Thus, at the onset of an episode of gas reflux lower oesophageal sphincter pressure had relaxed to 3 mmHg, or less, in 96% of instances. After gas loading of the stomach the prevalence of gas reflux was significantly less when the subjects were supine (1.2/10 min) than when they were sitting (6.8/10 min) (p less than 0.001). The lower oesophageal sphincter relaxations associated with most episodes of gas reflux had a distinctive pattern that resembled those of the lower oesophageal sphincter relaxations associated with acid gastro-oesophageal reflux.

Full text

PDF
639

Selected References

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

  1. Dent J. A new technique for continuous sphincter pressure measurement. Gastroenterology. 1976 Aug;71(2):263–267. [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. Dent J., Holloway R. H., Toouli J., Dodds W. J. Mechanisms of lower oesophageal sphincter incompetence in patients with symptomatic gastrooesophageal reflux. Gut. 1988 Aug;29(8):1020–1028. doi: 10.1136/gut.29.8.1020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dent J., Holloway R. H., Toouli J., Dodds W. J. Mechanisms of lower oesophageal sphincter incompetence in patients with symptomatic gastrooesophageal reflux. Gut. 1988 Aug;29(8):1020–1028. doi: 10.1136/gut.29.8.1020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dodds W. J., Dent J., Hogan W. J., Helm J. F., Hauser R., Patel G. K., Egide M. S. Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982 Dec 16;307(25):1547–1552. doi: 10.1056/NEJM198212163072503. [DOI] [PubMed] [Google Scholar]
  6. Falempin M., Mei N., Rousseau J. P. Vagal mechanoreceptors of the inferior thoracic oesophagus, the lower oesophageal sphincter and the stomach in the sheep. Pflugers Arch. 1978 Jan 31;373(1):25–30. doi: 10.1007/BF00581145. [DOI] [PubMed] [Google Scholar]
  7. Goyal R. K., Rattan S. Nature of the vagal inhibitory innervation to the lower esophageal sphincter. J Clin Invest. 1975 May;55(5):1119–1126. doi: 10.1172/JCI108013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Holloway R. H., Hongo M., Berger K., McCallum R. W. Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology. 1985 Oct;89(4):779–784. doi: 10.1016/0016-5085(85)90572-4. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. Little A. F., Cox M. R., Martin C. J., Dent J., Franzi S. J., Lavelle R. Influence of posture on transient lower oesophageal sphincter relaxation and gastro-oesophageal reflux in the dog. J Gastroenterol Hepatol. 1989 Jan-Feb;4(1):49–54. doi: 10.1111/j.1440-1746.1989.tb00806.x. [DOI] [PubMed] [Google Scholar]
  11. 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]
  12. Martin C. J., Patrikios J., Dent J. Abolition of gas reflux and transient lower esophageal sphincter relaxation by vagal blockade in the dog. Gastroenterology. 1986 Oct;91(4):890–896. doi: 10.1016/0016-5085(86)90691-8. [DOI] [PubMed] [Google Scholar]
  13. Mittal R. K., McCallum R. W. Characteristics of transient lower esophageal sphincter relaxation in humans. Am J Physiol. 1987 May;252(5 Pt 1):G636–G641. doi: 10.1152/ajpgi.1987.252.5.G636. [DOI] [PubMed] [Google Scholar]
  14. Paintal A. S. Vagal sensory receptors and their reflex effects. Physiol Rev. 1973 Jan;53(1):159–227. doi: 10.1152/physrev.1973.53.1.159. [DOI] [PubMed] [Google Scholar]
  15. Paterson W. G., Rattan S., Goyal R. K. Experimental induction of isolated lower esophageal sphincter relaxation in anesthetized opossums. J Clin Invest. 1986 Apr;77(4):1187–1193. doi: 10.1172/JCI112420. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. WINSHIP D. H., ZBORALSKE F. F., WEBER W. N., SOERGEL K. H. ESOPHAGUS IN RUMINATION. Am J Physiol. 1964 Dec;207:1189–1194. doi: 10.1152/ajplegacy.1964.207.6.1189. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES