Abstract
Recently, there has been clinical interest in the effect of different body positions on esophageal motility. This study aimed to identify the effect of three different body positions on esophageal motility using high-resolution manometry. Thirteen healthy adults swallowed 5 mL of water in the upright, supine, and bridge positions. For the bridge position, each subject raised their waist against gravity, placed a cushion under their back, and bent their knees. The proximal contractile integral (PCI) and distal contractile integral (DCI), integrated relaxation pressure (IRP), distal latency (DL), peristaltic breaks (PBs), intrabolus pressure (IBP), and expiratory and inspiratory esophagoesophageal junction (EGJ) pressure were measured. In the bridge position, PCI, DCI, IRP, and expiratory and inspiratory EGJ pressure were significantly higher than those in the upright position (bridge PCI vs. upright PCI [p = 0.001], bridge DCI vs. upright DCI [p < 0.001], bridge IRP vs. upright IRP [p = 0.018], bridge EGJ pressure vs. upright EGJ pressure [expiratory: p = 0.001] [inspiratory: p < 0.001]). PBs were significantly shorter and DL was significantly longer in the bridge position compared to upright (bridge PBs vs. upright PBs [p = 0.001], bridge DL vs. upright DL [p = 0.001]). IBP was significantly higher in the bridge position compared to supine (bridge IBP vs. supine IBP [p = 0.01]). These results demonstrated changes in esophageal motility according to changes in position while swallowing, where esophageal contractions became stronger against gravity. Further study is required to examine the effectiveness of swallowing in the bridge position.
Highlights
Swallowing involves four phases: oral preparatory, oral propulsive, pharyngeal, and esophageal [1]
We focused on the effect of body position and gravity on esophageal motility in order to enhance esophageal contractility
De Leon et al [17] identified that the lower esophageal sphincter (LES) pressure significantly increased in the Trendelenburg position, which is an adjusted supine position with the patient’s head tilted lower than their feet; they did not investigate the distal esophageal peristalsis
Summary
Swallowing involves four phases: oral preparatory, oral propulsive, pharyngeal, and esophageal [1]. The use of solid-state pressure sensors instead of the conventional water-perfused pressure sensors enables a faster response to changes in pressure This results in a more detailed assessment and makes it possible to study the. Zifan et al [18] investigated the effects of swallowing between the supine and Trendelenburg positions on the movement of the bolus, distension, and contractions of the esophagus in normal healthy subjects. They identified that esophageal contractile integrals, including those of the distal esophagus, were significantly higher in the Trendelenburg position than in the supine. This study investigates a comprehensive set of parameters using three different swallowing positions
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