Effects of effortful swallow on esophageal function in healthy adults
Article first published online: 8 FEB 2012
© 2012 Blackwell Publishing Ltd
Neurogastroenterology & Motility
Volume 24, Issue 3, pages 252–e108, March 2012
How to Cite
Nekl, C. G., Lintzenich, C. R., Leng, X., Lever, T. and Butler, S. G. (2012), Effects of effortful swallow on esophageal function in healthy adults. Neurogastroenterology & Motility, 24: 252–e108. doi: 10.1111/j.1365-2982.2011.01864.x
- Issue published online: 8 FEB 2012
- Article first published online: 8 FEB 2012
- Received: 17 June 2011 Accepted for publication: 13 December 2011
- effortful swallow;
Background Treatment for esophageal dysmotility is currently limited to primarily pharmacologic intervention, which has questionable utility and frequently associated negative side effects. A potential behavioral intervention for esophageal dysmotility is the effortful oropharyngeal swallow. A previous pilot study using water perfusion manometry found an increase in distal esophageal amplitudes during effortful vs non-effortful swallowing. The current study sought to duplicate the previous study with improvements in methodology.
Methods The effects of swallow condition (effortful vs non-effortful), sensor site, and gender on esophageal amplitude, duration, velocity, and bolus clearance were examined for 18 adults (nine males and nine females, mean age = 29.9 years) via combined solid-state manometry and intraluminal impedance.
Key Results The effortful swallow condition yielded significantly higher esophageal amplitudes across all sensor locations (P < 0.05). Further, the effortful swallowing decreased the risk of incomplete bolus clearance when compared with non-effortful swallowing (OR: 0.51; 95% CI: 0.30–0.86).
Conclusions & Inferences With improved manometric instrumentation, larger participant numbers, and methodology that controlled for potential confounding factors, this study confirms and advances the results of the previous pilot study: Volitional manipulation of the oropharyngeal phase of swallowing using the effortful swallow indeed affects esophageal physiology. Thus, the effortful swallow offers a behavioral manipulation of the esophageal phase of swallowing, and future studies will determine its clinical potential for treating esophageal dysmotility in patient populations.