Deterioration of Muscle Function in the Human Esophagus with Age

Abstract

Most studies on the effect of aging on esophageal motor function have shown that peristaltic function deteriorates with age. Esophageal motor function is traditionally studied by means of manometry and radiography. Distension of the esophagus with evaluation of active and passive mechanical parameters have become available during recent years. In this study, we did a manometric swallow analysis and used the distension method to study esophageal properties and function during aging. An impedance planimetric probe with a bag for distension was placed in the distal esophagus of 25 healthy volunteers with a median age of 35 (range 23-86) years. Distensions were done at an infusion rate of 25 ml min(-1) with and without relaxation of neuromuscular activity with butylscopolamine. The infusion was reversed when moderate pain was experienced by the subjects. Swallow-induced contraction amplitudes decreased as function of age for persons older than 40 years (P < 0.05). The total and passive tension showed an exponential increase as function of the change in radius, whereas the active tension increased until it reached a local maximum point. The maximum active tension deteriorated as a function of age after the age of 40 years (P < 0.05). Furthermore, esophagus became stiffer with age. In conclusion, age-related changes of increased stiffness and reduced primary and secondary peristalsis were found in the human esophagus with a deterioration of esophageal function after the age of 40 years. Such changes may contribute to the high prevalence of reflux disease in elderly.

Effects of Age on Esophageal Motility: Use of High-resolution Esophageal Impedance Manometry

“…43 Several studies showed that esophageal distensibilities are decreased and LES pressures are higher in aged subjects. 5,[44][45][46] However, basal LES pressures of the older group was not higher than that of the younger group which needs explanation regarding age definition or characteristics of the aged group. In the present study the definition of the aged group were subjects over 65 years old, which is lower than that of previously published papers.…”

“…2,3 Several studies showed decreased sphincter relaxations and decreased esophageal contraction and dilatation in the aged people. [4][5][6] The neural control of gastrointestinal function, including esophageal motility is related to enteric neurons. 7,8 It has been shown that changes in esophageal physiology is associated with loss of esophageal myenteric plexus neurons, which are part of the enteric nervous system (ENS) and lie within the smooth muscle layers of the esophageal wall in the aged population.…”

Further Assessment of Atrial Fibrillation as a Risk Factor for Gastroesophageal Reflux Disease: A Multicenter Questionnaire Survey

“…Gastroesophageal reflux disease (GERD) is drawing increasing attention due to the modern lifestyle, prevalence of obesity (4), sleep apnea (5) and metabolic syndrome (6), progression of aging and decline of Helicobacter pylori infection in developed countries (7). Lower esophageal sphincter relaxation is frequently observed in obese populations (4) and those with a full stomach (8) or sleep apnea (5), whereas hiatal hernias are prevalent in the elderly (9).…”

“…Although AF and GERD share the same predisposing factors, including metabolic syndrome (3,6), sleep apnea (2,5) and senescence (1,9), their association remains controversial. We conducted a preliminary questionnaire study and reported that the coexistence of AF and GERD is not unusual in Japan (10).…”

Morphometric analysis of muscularis proper and myenteric plexus of the normal human oesophagus. Age related changes

“…On the other hand, deleterious effects of aging on the structure and function of many organs are well recognised [9,16,17,19,27]. Oesophageal dysfunctions related to aging are clinically well described [4,8,10,14,23], but histological reports are not numerous and mostly focus on the swallowing reflex structures and the oesophageal sphincter [3,12,20,30]. Interestingly enough, histomorphometric examinations focused on the other parts of the human oesophagus are absent.…”