Dysphagia

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

Pathological pharyngo-esophageal interactions

  • Benson T. Massey
Article

Abstract

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 

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References

  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

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