Esophageal motility in the elderly.

Abstract

The effect of age on motor function of the esophagus was studied manometrically by comparing 49 asymptomatic subjects over 60 years of age with 43 similar subjects under 40 years of age. The resting pressures and the responses to deglutition were recorded in the esophagus, lower esophageal sphincter (LES), and the stomach. Significant differences in motility patterns were seen between the two age groups. Although the pressures in the LES were similar in the two groups, the LES response to deglutition was inadequate in 17.8% of swallows in those over 60 years of age and in only 5.9% in those under 40 years (P<0.003). Inadequate LES response was characterized by either a complete absence of response or absence of contractile phase. The amplitude of sphincteric response to deglutition was less in older persons due mainly to a decrease in the amplitude of contraction. In the body of the esophagus the peristaltic contractions were weaker and progressed more slowly in the older group. The incidence of disordered contractions was significantly higher in the older group (25.3% vs 8.2%, P<0.001). Spontaneous gastroesophageal reflux was seen in 9 of the 49 subjects over 60 years of age and in none below 40 years of age. The changes in swallowing patterns indicate a degree of neuromuscular degeneration. They simulate those seen in neuromuscular disorders of esophagus such as diffuse spasm and gastroesophageal reflux. Recognition of the age-related changes is therefore important in interpreting esophageal motility patterns in the elderly.