TY - JOUR
T1 - Changes in esophageal and lower esophageal sphincter motility with healthy aging
AU - Besanko, L
AU - Burgstad, Carly
AU - Cock, Charles
AU - Heddle, Richard
AU - Fraser, Allison
AU - Fraser, Robert
PY - 2014
Y1 - 2014
N2 - Background & Aims: Swallowing difficulties become increasingly prevalent in older age. Differences exist in lower esophageal sphincter (LES) function between older and younger patients with dysphagia, but the contribution of aging per se to these is unclear. Methods: Esophageal motor function was measured using high resolution manometry in older (aged 81±1.7 yrs) and younger (23±1.7 yrs) asymptomatic healthy adults. After baseline recording, motility was assessed by swallowing boluses of liquid (right lateral and upright postures) and solids. Basal LES pressure, integrated relaxation pressure, distal esophageal peristaltic amplitude and velocity were measured. Data are presented as mean ± SEM. Results: Despite a trend for lower basal LES pressure (15.7±2.9 mmHg vs. 21.0±0.2mmHg; P=0.08), completeness of LES relaxation was reduced in older subjects (liquid RL: P=0.003; UR: P=0.007; solid: P=0.03), with higher integrated relaxation pressure when upright (liquid: 6.9±1.1 vs. 3.1±0.4 mmHg; P=0.01; solids: 8.1±1.1 vs. 3.6±0.3 mmHg; P=0.001) and a longer time to recovery after liquid boluses (right lateral: P=0.01; upright: P=0.04). In young, but not older adults, esophageal peristaltic velocity was increased when upright (3.6±0.2 cm/sec; P=0.04) and reduced with solids (3.0±0.1 cm/sec; P=0.03). Distal contraction amplitude was higher with solids in the young (51.8± 7.9 mmHg) but not older (41.4±6.2 mmHg; P=0.03) individuals. In elderly subjects, the distal contractile integral was higher with liquid swallows in the upright posture (P=0.006). Conclusion: There are subtle changes in LES function even in asymptomatic older individuals. These agerelated changes may contribute to the development of dysphagia.
AB - Background & Aims: Swallowing difficulties become increasingly prevalent in older age. Differences exist in lower esophageal sphincter (LES) function between older and younger patients with dysphagia, but the contribution of aging per se to these is unclear. Methods: Esophageal motor function was measured using high resolution manometry in older (aged 81±1.7 yrs) and younger (23±1.7 yrs) asymptomatic healthy adults. After baseline recording, motility was assessed by swallowing boluses of liquid (right lateral and upright postures) and solids. Basal LES pressure, integrated relaxation pressure, distal esophageal peristaltic amplitude and velocity were measured. Data are presented as mean ± SEM. Results: Despite a trend for lower basal LES pressure (15.7±2.9 mmHg vs. 21.0±0.2mmHg; P=0.08), completeness of LES relaxation was reduced in older subjects (liquid RL: P=0.003; UR: P=0.007; solid: P=0.03), with higher integrated relaxation pressure when upright (liquid: 6.9±1.1 vs. 3.1±0.4 mmHg; P=0.01; solids: 8.1±1.1 vs. 3.6±0.3 mmHg; P=0.001) and a longer time to recovery after liquid boluses (right lateral: P=0.01; upright: P=0.04). In young, but not older adults, esophageal peristaltic velocity was increased when upright (3.6±0.2 cm/sec; P=0.04) and reduced with solids (3.0±0.1 cm/sec; P=0.03). Distal contraction amplitude was higher with solids in the young (51.8± 7.9 mmHg) but not older (41.4±6.2 mmHg; P=0.03) individuals. In elderly subjects, the distal contractile integral was higher with liquid swallows in the upright posture (P=0.006). Conclusion: There are subtle changes in LES function even in asymptomatic older individuals. These agerelated changes may contribute to the development of dysphagia.
KW - Aging
KW - Esophageal motility
KW - Lower esophageal sphincter
KW - Manometry
UR - http://www.scopus.com/inward/record.url?scp=84906846004&partnerID=8YFLogxK
U2 - 10.1543/jgld.2014.1121
DO - 10.1543/jgld.2014.1121
M3 - Article
SN - 1841-8724
VL - 23
SP - 243
EP - 248
JO - Journal of Gastrointestinal and Liver Diseases
JF - Journal of Gastrointestinal and Liver Diseases
IS - 3
ER -