Changes in esophageal and lower esophageal sphincter motility with healthy aging

L Besanko, Carly Burgstad, Charles Cock, Richard Heddle, Allison Fraser, Robert Fraser

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)243-248
    Number of pages6
    JournalJournal of Gastrointestinal and Liver Diseases
    Volume23
    Issue number3
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Aging
    • Esophageal motility
    • Lower esophageal sphincter
    • Manometry

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