Pharyngeal pump and esophageal transit

Abstract

In deglutition the pharynx appears to act as a pump to "inject" boluses into the esophagus. A new method for measuring the velocity profile of the leading edge of a radionuclide bolus has been developed and applied to boluses of different viscosity--water and treacle--in nine normal volunteers. The results show that the more viscous bolus (treacle) acquires a slower initial "injection" velocity (152 mm/sec vs 236 mm/sec) that only propels it over the proximal half of the esophagus. Peristaltic action must drive the bolus over the distal half. With water boluses, however, the higher initial velocity is sufficient to propel a part of the bolus at least to the gastroesophageal junction leaving minimal "work" to be performed by esophageal peristalsis. This confirms the important role of the pharyngeal pump in deglutition. The pump may be the major mechanism for ingestion of nonviscous liquids (water), peristalsis merely being required to "sweep up" what remains in the esophagus.

Exploration of Pharyngeal Swallowing by Audiosignal Recording

“…Certain authors have emphasized that the tongue and the pharynx act like a pump which propels water to the stomach at great speed whereas a more viscous bolus reaches halfway down the esophagus and is then evacuated by peristalsis [5,21]. Jacob et al [19] and Dantas et al [22] consider that when the viscosity of a bolus increases, resistance to passage increases, resulting in a decrease in speed of displacement of the bolus in the pharyngo-esophageal canal.…”

“…Scintigraphy [5,6] and the use of recent strain gauges [7] have also contributed. However, such methods necessitate sophisticated and expensive equipment for the interpretation of results.…”

Assessment of esophageal function in patients with myasthenia gravis

“…Swallowing is a complex neuromuscular process involving the oral cavity, tongue, pharynx, larynx, and the esophagus [2,7,11]. Normal esophageal motor activity consists of an orderly peristaltic contraction progressing from the pharynx over the cricopharyngeal sphincter to the tubular esophagus, and terminates in closure of the lower esophageal sphincter [7,8].…”

Functional evaluation of gastric transplants used in esophageal reconstruction

“…An explanation for the differences in transit between the two types of tubes may be inferred from the endoscopic examination: the gastric transplant had a different morphology, with no haustration and good tone. Another important factor is the proven role of the pharyngeal pumP in deglutition [18]. In these patients, without pharyngeal disorders affecting swallowing, the pump is the major mechanism for the ingestion of nonviscous liquids, and peristalsis is required merely to sweep down what remains in the esophagus [18].…”

“…Another important factor is the proven role of the pharyngeal pumP in deglutition [18]. In these patients, without pharyngeal disorders affecting swallowing, the pump is the major mechanism for the ingestion of nonviscous liquids, and peristalsis is required merely to sweep down what remains in the esophagus [18].…”