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

Abstract

Background/AimsDisturbances of esophageal motility have been reported to be more frequent the aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on esophageal motility using high-resolution esophageal impedance manometry (HRIM). MethodsEsophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (Group A, n = 32), 40-65 years (Group B, n = 185), and > 65 years (Group C, n = 62). Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures, integrated relaxation pressure, distal contractile integral, contractile front velocity, distal latency, and pressures and duration of contraction on 4 positions along the esophagus, and complete bolus transit were measured. ResultsBasal UES pressure was lower in Group C (P < 0.001) but there was no significant difference in the LES pressure among groups. Contractile duration on position 3 (10 cm from proximal LES high pressure zone) was longer in Group C (P = 0.001), and the contractile amplitude on position 4 (5 cm from proximal LES high pressure zone) was lower in Group C (P = 0.005). Distal contractile integral was lower in Group C (P = 0.037). Contractile front velocity (P = 0.015) and the onset velocity (P = 0.040) was lower in Group C. There was no significant difference in impedance values. ConclusionsThe decrease of UES pressure, distal esophageal motility, and peristaltic velocity might be related with esophageal symptoms in the aged population.

Characteristics of Patients With Esophageal Dysphagia Assessed by Chest X-Ray Imaging After Videofluoroscopic Swallowing Study

“…Age group of 65-79 years was associated with moderate to severe esophageal dilatation and showed a significant relationship with esophageal dysphagia. Reduced esophageal motility in old age has been attributed to weak peristalsis, slow bolus progression, and decreased esophageal sphincter pressure [19][20][21]. In the current study, based on the presence of esophageal residual barium after VFSS, older age is associated with esophageal dysphagia, a finding consistent with previous reports.…”

“…In our analysis, age over 80 years was not significantly associated with esophageal dysphagia. Very few studies have focused on the relationship between the more elderly age group and esophageal motility [20][21][22]. Andrews et al [23] compared esophageal motility of age over 80 years with a younger age group (mean age, 35 years), and there was no significant difference in the functional assessment and manometric findings.…”

Water Ingestion Dynamics in Patients With Achalasia: Influence of Sex and Age

“…Aging process has a clear influence on swallowing (19)(20)(21)(22)(23) . Swallowing capacity decreases as the individual gets older, with altered oral, pharyngeal and esophageal function (19) , manifested by prolongation of oral and pharyngeal phases (23) , esophageal motility abnormalities (23) , and reduction in the cross-sectional area of the upper esophageal sphincter opening during swallows (19) .…”

“…During the aging process, there is a loss of the esophageal myenteric plexus (25,26) , which explain the deterioration in esophageal motility and function in subjects with established esophageal motility disease (21) . This change, however, does not exacerbate esophageal dysfunction in achalasia, be it before or after treatment (24) or in Chagas' disease (12) .…”

Characterizing the proximal esophageal segment in patients with symptoms of esophageal dysmotility

“…The three most common esophageal motility disorders were IEM (16.3% of all patients), achalasia (14%), and EGJ outflow obstruction (13.6), similar to the findings of Alani et al 11 Among all patients undergoing HREM, PCI had a weak negatively correlation with age ( r = −0.29, P < .01). Previous studies have shown decrease in UES pressure, PCI, and DCI with increase in age 10,12 . Opioid use may negatively affect contractility of the striated muscles in the UES and smooth muscles in the distal esophagus 13,14 .…”