Effect of Swallowed Bolus Viscosity and Body Position on Esophageal Transit, Contraction and Perception of Transit

Abstract

-Background -The esophagus has a different response in relation to the characteristics of a swallowed bolus. Bolus viscosity and body position may affect esophageal contraction and transit. Objective -To investigate the effect of bolus viscosity and body position on esophageal contraction, transit and perception. Methods -Esophageal contraction, transit and perception of transit were evaluated in 26 asymptomatic volunteers, 13 men and 13 women aged 18-60 years, mean: 33.6 (12.2) years. Esophageal contraction (manometry) and transit (impedance) were measured with a solid state catheter with sensors located 5, 10, 15, and 20 cm from the lower esophageal sphincter. Each volunteer swallowed in duplicate and in random sequence a 5 mL low viscous (LV) liquid bolus of an isotonic drink with pH 3.3, and a 5 mL high viscous (HV) paste bolus, which was prepared with 7.5 g of instant food thickener diluted in 50 mL of water (pH: 6.4). Results -Total bolus transit time, in the sitting position, was longer with the HV bolus than with the LV bolus. Esophageal transit was longer in the supine position than in the sitting position. Bolus head advance time was longer with the HV bolus than with the LV bolus in both positions. Contraction esophageal amplitude was higher in the supine position than in the sitting position. The perception of bolus transit was more frequent with the HV bolus than with the LV bolus, without differences related to position. Conclusion -The viscosity of the swallowed bolus and body position during swallows has an influence on esophageal contractions, transit and perception of transit.

Dysphagia severity is related to the amplitude of distal contractile integral in patients with Jackhammer esophagus

“…Although intraluminal impedance measurement can be used to reliably assess bolus clearance in subjects with dysphagia and motility disorders, viscosity of bolus of the swallowed bolus has an influence on transit and perception of transit. 27,28 In conclusion, our data provide a pathophysiological insight revealing that dysphagia but not non-cardiac chest pain was associated with the disease defining metric of a novel hypercontractile disorder. Strikingly, these findings are of high clinical interest as we could point out that esophageal body contractions, reflected by the DCI, and not impaired bolus transit or obstructed outflow were associated with the perception of dysphagia in JE.…”

“…Bolus transit was only tested for liquids. Although intraluminal impedance measurement can be used to reliably assess bolus clearance in subjects with dysphagia and motility disorders, viscosity of bolus of the swallowed bolus has an influence on transit and perception of transit …”

Esophageal Motility in Men and Women Evaluated by High-Resolution Manometry

“…In the sitting position the proportion of abnormal contractions increase (2,10,12) , the distal contraction integral and the amplitude of contractions decrease (4,6,11,12) . It could be, at least in part, the explanation for the absence of difference between men and women.…”

“…Esophageal motility has the influence of body position (2,4,6,10,12) and the characteristics of the swallowed bolus (2,5,6,10) , and may also have the influence of gender.…”

The motility of esophageal sphincters during liquid and solid bolus swallows: a multicenter normative value study of high‐resolution manometry in China

“…The motility features of the esophagus in solid bolus swallows are less well described. A few studies tried to assess esophageal functions in solid bolus swallows with conventional manometry . However, the latter study has limitations in the pressure recording of the esophagus, especially of the esophageal sphincters.…”