Age-related impairment of esophagogastric junction relaxation and bolus flow time.

Autor:	Cock C; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Besanko LK; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Burgstad CM; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Thompson A; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Kritas S; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Heddle R; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Fraser RJ; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia., Omari TI; Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Richard Heddle, Robert JL Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park, South Australia 5041, Australia.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2017 Apr 21; Vol. 23 (15), pp. 2785-2794.
DOI:	10.3748/wjg.v23.i15.2785
Abstrakt:	Aim: To investigate the functional effects of abnormal esophagogastric (EGJ) measurements in asymptomatic healthy volunteers over eighty years of age. Methods: Data from 30 young controls (11 M, mean age 37 ± 11 years) and 15 aged subjects (9 M, 85 ± 4 years) were compared for novel metrics of EGJ-function: EGJ-contractile integral (EGJ-CI), "total" EGJ-CI and bolus flow time (BFT). Data were acquired using a 3.2 mm, 25 pressure (1 cm spacing) and 12 impedance segment (2 cm) solid-state catheter (Unisensor and MMS Solar GI system) across the EGJ. Five swallows each of 5 mL liquid (L) and viscous (V) bolus were analyzed. Mean values were compared using Student's t test for normally distributed data or Mann Whitney U-test when non-normally distributed. A P value < 0.05 was considered significant. Results: EGJ-CI at rest was similar for older subjects compared to controls. "Total" EGJ-CI, measured during liquid swallowing, was increased in older individuals when compared to young controls (O 39 ± 7 mmHg.cm vs C 18 ± 3 mmHg.cm; P = 0.006). For both liquid and viscous bolus consistencies, IRP4 was increased (L: 11.9 ± 2.3 mmHg vs 5.9 ± 1.0 mmHg, P = 0.019 and V: 14.3 ± 2.4 mmHg vs 7.3 ± 0.8 mmHg; P = 0.02) and BFT was reduced (L: 1.7 ± 0.3 s vs 3.8 ± 0.2 s and V: 1.9 ± 0.3 s vs 3.8 ± 0.2 s; P < 0.001 for both) in older subjects, when compared to young. A matrix of bolus flow and presence above the EGJ indicated reductions in bolus flow at the EGJ occurred due to both impaired bolus transport through the esophageal body ( i.e ., the bolus never reached the EGJ) and increased flow resistance at the EGJ ( i.e ., the bolus retained just above the EGJ). Conclusion: Bolus flow through the EGJ is reduced in asymptomatic older individuals. Both ineffective esophageal bolus transport and increased EGJ resistance contribute to impaired bolus flow. Competing Interests: Conflict-of-interest statement: There are no conflicts of interest. Professor Omari owns a patent on AIM pressure flow analysis methods, which are not reported on for this study.
Databáze:	MEDLINE
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