Logo image
Back
The impact of continuous positive airway pressure on the lower esophageal sphincter
Journal article   Peer reviewed

The impact of continuous positive airway pressure on the lower esophageal sphincter

Kelly L Shepherd, Richard H Holloway, David R Hillman and Peter R Eastwood
American journal of physiology: Gastrointestinal and liver physiology, Vol.292(5), pp.G1200-1205
2007
DOI: https://doi.org/10.1152/ajpgi.00476.2006
PMID: 17234890
url
PublishedView
Published (Version of Record)

Abstract

lower esophageal sphincter relaxation esophageal function gastroesophageal reflux
The lower esophageal sphincter (LES) is the primary barrier to gastroesophageal reflux. Reflux is associated with periods of LES relaxation, as occurs during swallowing. Continuous positive airway pressure (CPAP) has been shown to reduce reflux in individuals with and without sleep apnea, by an unknown mechanism. The aim of this study was to determine the effect of CPAP on swallow-induced LES relaxation. Measurements were made in 10 healthy, awake, supine individuals. Esophageal (Pes), LES (Ples), gastric (Pg), and barrier pressure to reflux (Pb = Ples − Pg) were recorded using a sleeve catheter during five swallows of 5 ml of water. This was repeated at four levels of CPAP (0, 5, 10, and 15 cmH2O). Pressures were measured during quiet breathing and during the LES relaxation associated with a swallow. Duration of LES relaxation was also recorded. During quiet breathing, CPAP significantly increased end-expiratory Pes, Ples, Pg, and Pb (P < 0.05). The increase in Pb was due to a disproportionate increase in Ples compared with Pg (P < 0.05). During a swallow, CPAP increased nadir Ples, Pg, and Pb and decreased the duration of LES relaxation (4.1 s with 0-cmH2O CPAP to 1.6 s on 15-cmH2O CPAP, P < 0.001). Pb increased with CPAP by virtue of a disproportionate increase in Ples compared with Pg. This may be due to either reflex activation of LES smooth muscle, or nonspecific transmission of pressure to the LES. The findings suggest CPAP may make the LES less susceptible to reflux by increasing Pb and decreasing the duration of LES relaxation.

Details

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: InCites

Metrics

33 Record Views
37 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
Citation topics
1 Clinical & Life Sciences
1.95 Gastrointestinal & Esophageal Diseases
1.95.541 GERD & Achalasia
Web Of Science research areas
Gastroenterology & Hepatology
Physiology
ESI research areas
Clinical Medicine
Logo image