, Volume 10, Issue 4, pp 232–234 | Cite as

Pathological pharyngo-esophageal interactions

  • Benson T. Massey


Because of their normally coordinated function and physical contiguity, the pharynx and esophagus are subject to pathologic interactions in various disease or iatrogenic states. A useful conceptualization of these pathologic interactions is that of abnormal bolus transport. Specific clinical examples are given in which abnormal pharyngo-esophageal interactions appear to result in abnormal bolus transport, with its attendant consequences.

Key words

Achalasia Esophagus Pharynx Upper exophageal sphincter Deglutition Deglutition disorders Noncardiac chest pain Belch Reflux 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Paterson WG, Rattan S, Goyal RK: Experimental induction of isolated lower esophageal sphincter relaxation in anesthetized opossums. J Clin Invest 77:1187–1193, 1986Google Scholar
  2. 2.
    Trifan A, Shaker R, Ren J, Mittal R, Saeian K, Dua K, Sui Z: Inhibition of resting lower esophageal sphincter pressure by pharyngeal water stimulation in man. Gastroenterology 106: A580, 1994Google Scholar
  3. 3.
    Saeian K, Shaker R, Sharma P, Trifan A, Ren J, Sui Z, Dua K: Effect of aging on the lower esophageal sphincter pressure (LESP) response to pharyngeal water stimulation. Gastroenterology 106:A631, 1994Google Scholar
  4. 4.
    Mittal RK, Stewart WR, Schirmer BD: Effect of a catheter in the pharynx on the frequency of transient lower esophageal sphincter relaxations. Gastroenterology 103:1236–1240, 1992Google Scholar
  5. 5.
    Dent J, Holloway RH, Toouli J, Dodds WJ: Mechanisms of lower oesophageal sphincter incompetence in patients with symptomatic gastroesophageal reflux. Gut 29:1020–1028, 1988Google Scholar
  6. 6.
    Kahrilas PJ, Dodds WJ, Dent J, Wyman JB, Hogan WJ, Arndorfer RC: Upper esophageal sphincter function during belching. Gastroenterology 91:133–140, 1986Google Scholar
  7. 7.
    Shaker R, Ren J, Kern M, Dodds WJ, Hogan WJ, Li Q: Mechanisms of airway protection and upper esophageal sphincter opening during belching. Am J Physiol 262:G621-G628, 1992Google Scholar
  8. 8.
    Kahrilas PJ, Dodds WJ, Hogan WJ: Dysfunction of the blech reflex: a cause of incapacitating chest pain. Gastroenterology 93:818–822, 1987Google Scholar
  9. 9.
    Waterman DC, Castell DO: Chest pain and inability to belch (letter). Gastroenterology 96:274–275, 1989Google Scholar
  10. 10.
    Gignoux K, Bost R, Hostein J, Turberg Y, Denis P, Cohard M, Wolf J-E, Fournet J: Role of upper esophageal reflex and belch reflex dysfunctions in noncardiac chest pain. Dig Dis Sci 38: 1909–1914, 1993Google Scholar
  11. 11.
    Massey BT, Hogan WJ, Dodds WJ, Dantas RO: Alteration of the upper esophageal sphincter belch reflex in patients with achalasia. Gastroenterology 103:1574–1579, 1992Google Scholar
  12. 12.
    Gerhardt DC, Shuck TJ, Bordeaux RA, Winship DH: Human upper esophageal sphincter. Response to volume, osmotic, and acid stimuli. Gastroenterology 75:268–274, 1978Google Scholar
  13. 13.
    Andreollo NA, Thompson DG, Kendall GPN, Earlam RJ: Functional relationships between cricopharyngeal sphincter and oesophageal body in response to graded intraluminal distension. Gut 29:161–166, 1988Google Scholar
  14. 14.
    Zhang ZG, Diamant NE: Repetitive contractions of the upper esophageal body and sphincter in achalasia. Dysphagia 9:12–19, 1994Google Scholar
  15. 15.
    Shaker R, Dodds WJ, Hogan WJ, Arndorfer RC, Hofmann C, Dent J: Mechanisms of esophago-pharyngeal acid regurgitation. Gastroenterology 100:A494, 1991Google Scholar
  16. 16.
    Massey BT, Hogan WJ, Dantas RO, Arndorfer RC, Dodds WJ: Conscious suppression of the upper esophageal sphincter belch reflex in normal volunteers. Gastroenterology 98:A373, 1990Google Scholar
  17. 17.
    Becker DJ, Castell DO: Acute airway obstruction in achalasia: possible role of defective belch reflex. Gastroenterology 97: 1323–1326, 1989Google Scholar
  18. 18.
    McConnel FMS: Analysis of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope 98:71–78, 1988Google Scholar
  19. 19.
    Dudnick RS, Castell JA, Castell DO: Abnormal upper esophageal sphincter function in achalasia. Am J Gastroenterol 87: 1712–1715, 1992Google Scholar
  20. 20.
    Jones B, Donner MW, Rubesin SE, Ravich WJ, Hendrix TR: Pharyngeal findings in 21 patients with achalasia of the esophagus. Dysphagia 2:87–92, 1987Google Scholar
  21. 21.
    Dantas RO, Cook IJ, Dodds WJ, Kern MK, Lang IM, Brasseur JG: Biomechanics of cricopharyngeal bars. Gastroenterology 99:1269–1274, 1990Google Scholar

Copyright information

© Springer-Verlag New York Inc 1995

Authors and Affiliations

  • Benson T. Massey
    • 1
  1. 1.MCW Dysphagia InstituteMedical College of WisconsinMilwaukeeUSA

Personalised recommendations