Effect of ageing on the upper and lower oesophageal sphincters.
ABSTRACT To determine the effect of ageing on length and resting pressure of the upper and lower oesophageal sphincters (UOSs, LOSs).
The effectiveness of upper and lower oesophageal sphincters (UOSs and LOSs, respectively) in the control of retrograde trans-sphincteric flow is influenced by sphincteric pressure and length.
Nine young and nine elderly healthy volunteers were studied. Resting UOS and LOS pressures were measured by sleeve devices and lengths were measured by the station pull-through technique.
The length of the UOS high pressure zone in the elderly (2.1 +/- 0.7 cm posterior; 1.9 +/- 0.1 cm anterior) was significantly shorter than that of the young (2.9 +/- 0.1 cm posterior; 3.1 +/- 0.2 cm anterior) (P< 0.01). Resting UOS pressure in the elderly (42 +/- 5 mmHg) was significantly lower than that of the young (62 +/- 7 mmHg) (P< 0.05). The intersphincteric length of the oesophagus in the elderly (21 +/- 0.2 cm) was similar to that of the young (21 +/- 0.4 cm). Total length of the LOS high pressure zone in the young (4.0 +/- 0.1 cm) was similar to that of the elderly (4.1 +/- 0.1 cm). LOS resting pressure was similar between young and elderly subjects (17 +/- 5 mmHg and 15 +/- 3 mmHg, respectively).
Ageing affects the UOS and LOS differently. With regard to resting pressure and length, ageing weakens the UOS, but has no significant effect on the LOS.
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ABSTRACT: Gustatory and chemical stimulations of the oral cavity and pharyngeal mucosa by carbonated water improve pharyngeal swallowing. We compared changes in pharyngeal swallowing and sensory aspects induced by a carbonated beverage preferred by Japanese with those induced by carbonated water, a sports drink, and tap water in healthy young subjects and elderly inpatients with no swallowing problems. The duration of laryngeal elevation (DOLE) for swallowing the carbonated beverage and water in the second session was shorter compared to that for water in the first session in the elderly subjects. The DOLE and the duration of suprahyoid muscle activity for swallowing were longer in the elderly subjects than in the young subjects for all beverages. Beverages that the subjects subjectively felt were easy to swallow were the sports drink and carbonated beverage, whereas they stated that carbonated water was less easy to swallow. In the elderly subjects, swallowing ability latently decreased, even though they had no problem swallowing in their daily lives, and it was assumed that the carbonated beverage improved pharyngeal swallowing. In addition, the carbonated beverage also influenced the subsequent swallowing of water, showing a persistent effect. It was suggested that carbonated beverages are easy to swallow and effective for the improving pharyngeal swallowing.Dysphagia 10/2013; 29(2). · 1.60 Impact Factor
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ABSTRACT: Objectives: Studies on young volunteers have shown that aerodigestive reflexes are triggered before the maximum volume of fluid that can safely collect in the hypopharynx before spilling into the larynx is exceeded (Hypopharyngeal Safe Volume: HPSV). The objective of this study was to determine the influence of aging on HPSV and Pharyngo-glottal Closure reflex; PGCR, Pharyngo-UES Contractile reflex; PUCR, and Reflexive Pharyngeal Swallow; RPS. Study design: Comparison between two groups of different age range. Methods: Ten young (25±3 SD years) and 10 elderly (77 ±3 SD) subjects were studied. PGCR, PUCR, and RPS were elicited by perfusing water into the pharynx rapidly and slowly. HPSV was determined by abolishing RPS with pharyngeal anesthesia. Results: Frequency-elicitation of PGCR and PUCR were significantly lower in the elderly compared to the young during slow water perfusion (47% versus 97% and 40% versus 90% respectively, p<0.001). RPS was absent in 5 of the 30 (17%) slow injections in the elderly group. In these elderly subjects, HPSV was exceeded and laryngeal penetration of the water was seen. The threshold volume to elicit PGCR, PUCR and RPS was significantly lower than the HPSV during rapid injections. Except for RPS, these volumes were also significantly lower than HPSV during slow injections. Conclusion: PGCR, PUCR, and RPS reflexes are triggered at a threshold volume significantly lower than the HPSV in both, the young and the elderly subjects. Lower frequency elicitation of PGCR, PUCR and RPS in the elderly can predispose them to the risks of aspiration.The Laryngoscope 11/2013; · 2.03 Impact Factor
Article: Schluckstörungen im Alter[Show abstract] [Hide abstract]
ABSTRACT: Im Rahmen des Alterns kommt es an vielen Organen zu deutlichen Struktur- und Funktionsveränderungen. Die gastrointestinalen Funktionen sind hier ebenfalls betroffen, obwohl sie wegen der Flüssigkeits-, Nahrungs- und Energieaufnahme wesentlich besser konserviert werden als andere Körperfunktionen. Bei den Veränderungen im Gastrointestinaltrakt und insbesondere bei den Schluckstörungen muss man unterscheiden zwischen typischen, z. T. physiologischen Alterungsvorgängen und Störungen, die sekundär infolge von Krankheiten entstehen. Sie treten mit zunehmendem Alter vermehrt auf und können zu Dysphagie führen. Bei den sekundären Erkrankungen handelt es sich vor allem um zerebrovaskuläre, neurodegenerative sowie insbesondere um maligne Erkrankungen des Oropharynx und des Ösophagus.Der Gastroenterologe 07/2012; 7(4).