Human upper esophageal sphincter pressure profile

Abstract

The pressure profile of the upper esophageal sphincter was characterized in nine normal subjects. Directionally oriented intraluminal pressures were recorded, at 0.5-cm intervals over a 6-cm segment that encompassed the sphincter, by a high-fidelity low-compliance recording system. The peak resting pressure was directed posteriorly, and the lowest pressures were recorded from the lateral orientations. Significant axial asymmetry was observed with peak posterior pressure 0.55 cm more distal than the anterior pressure. Calculations of variability of pressures recorded at each interval showed the peak pressure to be the most reproducible measurement for each subject. Isotonic saline and acid infusions into the esophagus distal to the sphincter resulted in increased sphincteric peak resting pressure (acid greater than saline). There was axial lengthening of the sphincteric pressure zone with infusion of acid and saline, but this observed increase in length was not significant except at the 50 mmHg level. Pressure profiles recorded during 0.5-cm station pull-throughs were virtually identical to those obtained by a rapid continuous pull-through technique.