lower esophageal sphincter

Summary

Summary: The physiologic or functional barrier to GASTROESOPHAGEAL REFLUX at the esophagogastric junction. Sphincteric muscles remain tonically contracted during the resting state and form the high-pressure zone separating the lumen of the ESOPHAGUS from that of the STOMACH. (Haubrich et al, Bockus Gastroenterology, 5th ed., pp399, 415)

Top Publications

  1. Meining A, Fackler A, Tzavella K, Storr M, Allescher H, Klauser A, et al. Lower esophageal sphincter pressure in patients with gastroesophageal reflux diseases and posture and time patterns. Dis Esophagus. 2004;17:155-8 pubmed
    Gastroesophageal reflux disease is caused predominantly by lower esophageal sphincter insufficiency...
  2. Babaei A, Bhargava V, Korsapati H, Zheng W, Mittal R. A unique longitudinal muscle contraction pattern associated with transient lower esophageal sphincter relaxation. Gastroenterology. 2008;134:1322-31 pubmed publisher
    ..of the longitudinal muscle of the esophagus may play a role in the relaxation and opening of the lower esophageal sphincter (LES)...
  3. Herbella F, Sweet M, Tedesco P, Nipomnick I, Patti M. Gastroesophageal reflux disease and obesity. Pathophysiology and implications for treatment. J Gastrointest Surg. 2007;11:286-90 pubmed
    ..morbidly obese (body mass index (BMI) > or =35) and nonmorbidly patients (BMI <35) with GERD: (a) lower esophageal sphincter (LES) profile; (b) esophageal body function; and (c) esophageal acid exposure...
  4. Wu J, Mui L, Cheung C, Chan Y, Sung J. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132:883-9 pubmed
    ..We evaluated the association between obesity and function of lower esophageal sphincter (LOS) in subjects without GERD.
  5. Ayazi S, Hagen J, Chan L, Demeester S, Lin M, Ayazi A, et al. Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. J Gastrointest Surg. 2009;13:1440-7 pubmed publisher
    ..The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms.
  6. Dundon J, Davis S, Hazey J, Narula V, Muscarella P, Melvin W. Radiofrequency energy delivery to the lower esophageal sphincter (Stretta procedure) does not provide long-term symptom control. Surg Innov. 2008;15:297-301 pubmed publisher
    The Stretta procedure (radiofrequency energy application to the lower esophageal sphincter) is a unique endoluminal technique for the management of gastroesophageal reflux...
  7. Niedringhaus M, Jackson P, Evans S, Verbalis J, Gillis R, Sahibzada N. Dorsal motor nucleus of the vagus: a site for evoking simultaneous changes in crural diaphragm activity, lower esophageal sphincter pressure, and fundus tone. Am J Physiol Regul Integr Comp Physiol. 2008;294:R121-31 pubmed
    ..of our study were to determine the CNS site that controls the CD and whether simultaneous changes in lower esophageal sphincter (LES) pressure and CD activity occur when this site is activated...
  8. Clarke J, Jagannath S, Kalloo A, Long V, Beitler D, Kantsevoy S. An endoscopically implantable device stimulates the lower esophageal sphincter on demand by remote control: a study using a canine model. Endoscopy. 2007;39:72-6 pubmed
    ..Selective stimulation to increase lower esophageal sphincter (LES) pressure may be useful in the control of gastroesophageal reflux disease...
  9. Thorn K, Thörn S, Wattwil M. The effects on the lower esophageal sphincter of sevoflurane induction and increased intra-abdominal pressure during laparoscopy. Acta Anaesthesiol Scand. 2006;50:978-81 pubmed
    ..patients was to investigate the effects of sevoflurane during inhalation induction on the lower esophageal sphincter pressure (LESP) and barrier pressure (BrP)...

More Information

Publications62

  1. Küper M, Kramer K, Kirschniak A, Kischniak A, Zdichavsky M, Schneider J, et al. Dysfunction of the lower esophageal sphincter and dysmotility of the tubular esophagus in morbidly obese patients. Obes Surg. 2009;19:1143-9 pubmed publisher
    ..Morbid obesity is associated with gastroesophageal reflux (GERD). The aim of this prospective study was to determine esophageal motility in asymptomatic morbidly obese patients and compare it to non-obese individuals...
  2. Babaei A, Bhargava V, Mittal R. Upper esophageal sphincter during transient lower esophageal sphincter relaxation: effects of reflux content and posture. Am J Physiol Gastrointest Liver Physiol. 2010;298:G601-7 pubmed publisher
    Although some studies show that the upper esophageal sphincter (UES) contracts during transient lower esophageal sphincter relaxation (TLESR), others show that it relaxes...
  3. Ayazi S, Hagen J, Zehetner J, Ross O, Wu C, Oezcelik A, et al. The value of high-resolution manometry in the assessment of the resting characteristics of the lower esophageal sphincter. J Gastrointest Surg. 2009;13:2113-20 pubmed publisher
    ..There has been less emphasis on the use of HRM to evaluate the lower esophageal sphincter (LES) resting pressure and length, both factors important in LES barrier function...
  4. Massey B, Simuncak C, LeCapitaine Dana N, Pudur S. Transient lower esophageal sphincter relaxations do not result from passive opening of the cardia by gastric distention. Gastroenterology. 2006;130:89-95 pubmed
    Transient lower esophageal sphincter relaxation is the main mechanism for gastroesophageal reflux...
  5. Corley D, Levin T, Habel L, Buffler P. Barrett's esophagus and medications that relax the lower esophageal sphincter. Am J Gastroenterol. 2006;101:937-44 pubmed
    ..We evaluated patients with a high-risk condition, Barrett's esophagus, to identify risk factors that may act early in the carcinogenic process...
  6. Shafik A, Shafik I, El Sibai O, Mostafa R. Effect of lower esophageal sphincter distension and acidification on esophageal pressure and electromyographic activity: the identification of the "sphinctero-esophageal excitatory reflex". Ann Thorac Surg. 2005;79:1126-31; discussion 1131 pubmed
    ..We investigated the hypothesis that lower esophageal sphincter (LES) dilatation rather than the refluxed acid affected reflex increase in the esophageal peristaltic ..
  7. Zou D, Chen W, Iwakiri K, Rigda R, Tippett M, Holloway R. Inhibition of transient lower esophageal sphincter relaxations by electrical acupoint stimulation. Am J Physiol Gastrointest Liver Physiol. 2005;289:G197-201 pubmed
    ..Gastric distension is the major trigger for transient lower esophageal sphincter (LES) relaxations (TLESRs)...
  8. Torashima Y, Uezono Y, Kanaide M, Ando Y, Enjoji A, Kanematsu T, et al. Presence of GABA(B) receptors forming heterodimers with GABA(B1) and GABA(B2) subunits in human lower esophageal sphincter. J Pharmacol Sci. 2009;111:253-9 pubmed
    ..for the management of gastro-esophageal reflux disease, but whether the compound acts directly at the lower esophageal sphincter (LES) remains to be elucidated...
  9. Lord R, Demeester S, Peters J, Hagen J, Elyssnia D, Sheth C, et al. Hiatal hernia, lower esophageal sphincter incompetence, and effectiveness of Nissen fundoplication in the spectrum of gastroesophageal reflux disease. J Gastrointest Surg. 2009;13:602-10 pubmed publisher
    ..The aims of this study were to investigate (1) the role of mechanical factors including hiatal hernia and lower esophageal sphincter (LES) competence in the spectrum of GERD and (2) outcomes of Nissen fundoplication.
  10. Jiang Y, Bhargava V, Mittal R. Mechanism of stretch-activated excitatory and inhibitory responses in the lower esophageal sphincter. Am J Physiol Gastrointest Liver Physiol. 2009;297:G397-405 pubmed publisher
    ..found that an orally directed stretch of the esophagus activates a neurally mediated relaxation of the lower esophageal sphincter (LES)...
  11. Omari T. Apnea-associated reduction in lower esophageal sphincter tone in premature infants. J Pediatr. 2009;154:374-8 pubmed publisher
    ..To characterize esophageal motility during episodes of prolonged apnea in premature infants...
  12. Lehmann A. Novel treatments of GERD: focus on the lower esophageal sphincter. Eur Rev Med Pharmacol Sci. 2008;12 Suppl 1:103-10 pubmed
    ..The lower esophageal sphincter (LES) plays a crucial role in maintaining the mechanical barrier necessary for prevention of gastric ..
  13. Schneider J, Kuper M, Konigsrainer A, Brücher B. Transient lower esophageal sphincter relaxation in morbid obesity. Obes Surg. 2009;19:595-600 pubmed publisher
    ..Gastroesophageal reflux is caused predominantly by transient lower esophageal sphincter relaxations (TLESRs)...
  14. Hamoui N, Lord R, Hagen J, Theisen J, Demeester T, Crookes P. Response of the lower esophageal sphincter to gastric distention by carbonated beverages. J Gastrointest Surg. 2006;10:870-7 pubmed
    Gastroesophageal reflux disease often occurs in patients with normal resting pressure and length of the lower esophageal sphincter. Such patients often have postprandial reflux. The mechanism of postprandial reflux remains controversial...
  15. Lehmann A, Antonsson M, Holmberg A, Blackshaw L, Brändén L, Brauner Osborne H, et al. (R)-(3-amino-2-fluoropropyl) phosphinic acid (AZD3355), a novel GABAB receptor agonist, inhibits transient lower esophageal sphincter relaxation through a peripheral mode of action. J Pharmacol Exp Ther. 2009;331:504-12 pubmed publisher
    ..We describe a new therapeutic approach for GERD, based on inhibition of transient lower esophageal sphincter relaxation (TLESR) with a proposed peripherally acting GABA(B) receptor agonist, (R)-(3-amino-2-..
  16. Cheng L, Harnett K, Cao W, Liu F, Behar J, Fiocchi C, et al. Hydrogen peroxide reduces lower esophageal sphincter tone in human esophagitis. Gastroenterology. 2005;129:1675-85 pubmed
    We have previously used the normal lower esophageal sphincter (N-LES) of human organ donors to examine the physiologic signal transduction of lower esophageal sphincter (LES) circular muscle...
  17. Semeniuk J, Kaczmarski M, Uścinowicz M. Manometric study of lower esophageal sphincter in children with primary acid gastroesophageal reflux and acid gastroesophageal reflux secondary to food allergy. Adv Med Sci. 2008;53:283-92 pubmed publisher
    The comparison of values of selected lower esophageal sphincter (LES) manometric parameters measured in children suspected of gastroesophageal reflux disease (GERD) (preliminary study) and in children with primary acid GER and acid GER ..
  18. Shepherd K, Holloway R, Hillman D, Eastwood P. The impact of continuous positive airway pressure on the lower esophageal sphincter. Am J Physiol Gastrointest Liver Physiol. 2007;292:G1200-5 pubmed
    The lower esophageal sphincter (LES) is the primary barrier to gastroesophageal reflux. Reflux is associated with periods of LES relaxation, as occurs during swallowing...
  19. Turan A, Wo J, Kasuya Y, Govinda R, Akca O, Dalton J, et al. Effects of dexmedetomidine and propofol on lower esophageal sphincter and gastroesophageal pressure gradient in healthy volunteers. Anesthesiology. 2010;112:19-24 pubmed publisher
    Many anesthetics reduce lower esophageal sphincter pressure (LESP)...
  20. Jensen J, Lehmann A, Uvebrant A, Carlsson A, Jerndal G, Nilsson K, et al. Transient lower esophageal sphincter relaxations in dogs are inhibited by a metabotropic glutamate receptor 5 antagonist. Eur J Pharmacol. 2005;519:154-7 pubmed
    Transient lower esophageal sphincter relaxation is the major mechanism for gastroesophageal reflux...
  21. Braghetto I, Lanzarini E, Korn O, Valladares H, Molina J, Henriquez A. Manometric changes of the lower esophageal sphincter after sleeve gastrectomy in obese patients. Obes Surg. 2010;20:357-62 pubmed publisher
    ..Laparoscopic sleeve gastrectomy has been accepted as an option for surgical treatment of obesity. After surgery, some patients present reflux symptoms associated with endoscopic esophagitis, therefore PPI's treatment must be indicated...
  22. Thorn K, Thorn S, Wattwil M. The effects of cricoid pressure, remifentanil, and propofol on esophageal motility and the lower esophageal sphincter. Anesth Analg. 2005;100:1200-3 pubmed
    ..purpose of this study was to investigate the effects of cricoid pressure, remifentanil, and propofol on lower esophageal sphincter (LES) and esophageal motility...
  23. Zhang Y, Carmichael S, Wang X, Huizinga J, Paterson W. Neurotransmission in lower esophageal sphincter of W/Wv mutant mice. Am J Physiol Gastrointest Liver Physiol. 2010;298:G14-24 pubmed publisher
    ..ICC) in nitrergic neurotransmission to gastrointestinal smooth muscle, circular smooth muscle from the lower esophageal sphincter (LES) of W/W(v) wild-type and mutant (ICC-deficient) mice were studied by using intracellular and ..
  24. Pandolfino J, Zhang Q, Ghosh S, Han A, Boniquit C, Kahrilas P. Transient lower esophageal sphincter relaxations and reflux: mechanistic analysis using concurrent fluoroscopy and high-resolution manometry. Gastroenterology. 2006;131:1725-33 pubmed
    ..was to perform a detailed analysis of the mechanics leading to esophagogastric junction (EGJ) opening during transient lower esophageal sphincter relaxations (tLESRs) using high-resolution manometry coupled with simultaneous fluoroscopy.
  25. Kim S, Youm J, Lee D, Park S, Shin C, Ryu J, et al. Effect of hydrogen peroxide on VIP-induced relaxation of the cat lower esophageal sphincter. Arch Pharm Res. 2007;30:1419-25 pubmed
    We investigated the effects of hydrogen peroxide (H2O2) on relaxation of the cat lower esophageal sphincter (LES). Vasoactive intestinal peptide (VIP) caused dose-dependent relaxation of LES, and H2O2 reduced VIP-induced relaxation...
  26. Agrawal A, Roberts J, Sharma N, Tutuian R, Vela M, Castell D. Symptoms with acid and nonacid reflux may be produced by different mechanisms. Dis Esophagus. 2009;22:467-70 pubmed publisher
    ..The MII-pH catheter contains six impedance segments placed 3, 5, 7, 9, 15, and 17 cm above the lower esophageal sphincter (LES). A pH electrode at 5 cm above the LES identifies the type of reflux, i.e. acid or nonacid...
  27. Sinn D, Choi Y, Kim J, Kim E, Son H, Kim J, et al. Change in cross-sectional area of esophageal muscle does not correlate with the outcome of achalasia after pneumatic balloon dilatation. J Gastroenterol Hepatol. 2010;25:539-43 pubmed publisher
  28. Basseri B, Conklin J, Pimentel M, Tabrizi R, Phillips E, Simsir S, et al. Esophageal motor dysfunction and gastroesophageal reflux are prevalent in lung transplant candidates. Ann Thorac Surg. 2010;90:1630-6 pubmed publisher
    ..We evaluated LTx candidates for esophageal motor abnormalities and gastroesophageal reflux...
  29. McMahon B, Frøkjaer J, Liao D, Kunwald P, Drewes A, Gregersen H. A new technique for evaluating sphincter function in visceral organs: application of the functional lumen imaging probe (FLIP) for the evaluation of the oesophago-gastric junction. Physiol Meas. 2005;26:823-36 pubmed
    ..The technique may be useful in accessing the role of the OGJ in diseases such as gastroesophageal reflux disease (GORD) and achalasia and their treatments with surgical and endoscopic therapies...
  30. van Soest E, Dieleman J, Siersema P, Schoof L, Sturkenboom M, Kuipers E. Tricyclic antidepressants and the risk of reflux esophagitis. Am J Gastroenterol. 2007;102:1870-7 pubmed
    Incompetence of the lower esophageal sphincter (LES) is a key factor in the pathogenesis of gastroesophageal reflux disease (GERD)...
  31. Boeckxstaens G, Jonge W, van den Wijngaard R, Benninga M. Achalasia: from new insights in pathophysiology to treatment. J Pediatr Gastroenterol Nutr. 2005;41 Suppl 1:S36-7 pubmed
  32. Mercado U, Arroyo de Anda R, Avendano L, Araiza Casillas R, Avendaño Reyes M. Metoclopramide response in patients with early diffuse systemic sclerosis. Effects on esophageal motility abnormalities. Clin Exp Rheumatol. 2005;23:685-8 pubmed
    To assess the metoclopramide response in patients with early diffuse systemic sclerosis (dSSc) and the acute effects of intravenous (IV) metoclopramide on the lower esophageal sphincter (LES).
  33. Arasaki C, Del Grande J, Yanagita E, Alves A, Oliveira D. Incidence of regurgitation after the banded gastric bypass. Obes Surg. 2005;15:1408-17 pubmed
    ..This study investigated the risk of becoming a chronic regurgitator, by considering silicone ring size and lower esophageal sphincter (LES) function, and their relationship with weight loss.
  34. Lehmann A, Holmberg A, Bhatt U, Bremner Danielsen M, Brändén L, Elg S, et al. Effects of (2R)-(3-amino-2-fluoropropyl)sulphinic acid (AFPSiA) on transient lower oesophageal sphincter relaxation in dogs and mechanism of hypothermic effects in mice. Br J Pharmacol. 2005;146:89-97 pubmed
    ..High doses of the compound induce hypothermia in the mouse, which probably is attributable to activation of the GABA(A) receptor. The latter effect may be caused both by AFPSiA and its oxidised sulphonic acid metabolite AFPSoA...
  35. Marcovechio Fonseca C, Martinez J, Piesciotto A, Yanagita E, Denardin O, Herani Filho B. Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients. Dis Esophagus. 2008;21:118-24 pubmed publisher
    There is controversy in the literature regarding the motor function behavior of the lower esophageal sphincter and esophagus following partial gastrectomy...
  36. Iwakiri K, Tanaka Y, Kawami N, Sano H, Kotoyori M, Sakamoto C. [Pathophysiology of gastroesophageal reflux disease: motility factors]. Nihon Rinsho. 2007;65:829-35 pubmed
    ..Transient lower esophageal sphincter relaxation(TLESR) is the major mechanism of acid reflux in both healthy subjects (HS) and in patients ..
  37. Eastwood P, Katagiri S, Shepherd K, Hillman D. Modulation of upper and lower esophageal sphincter tone during sleep. Sleep Med. 2007;8:135-43 pubmed
    The pressures generated within the upper esophageal sphincter (P(UES)) and lower esophageal sphincter (P(LES)) reflect the integrity of these barriers to gastroesophageal and pharyngoesophageal reflux, respectively...
  38. Shafik A, El Sibai O, Shafik A, Mostafa R, Shafik I. Effect of straining on the lower esophageal sphincter: identification of the "straining-esophageal reflex" and its role in gastroesophageal competence mechanism. J Invest Surg. 2004;17:191-6 pubmed
    ..We investigated the hypothesis that the lower esophageal sphincter (LES) undergoes phasic contraction on IAP increase, with a resulting inhibition of the stress GER...
  39. Misra A, Chourasia D, Ghoshal U. Manometric and symptomatic spectrum of motor dysphagia in a tertiary referral center in northern India. Indian J Gastroenterol. 2010;29:12-6 pubmed publisher
    ..We studied the spectrum of motor dysphagia in a northern Indian tertiary referral center...
  40. Zhang Y, Miller D, Paterson W. TREK-1 channels do not mediate nitrergic neurotransmission in circular smooth muscle from the lower oesophageal sphincter. Br J Pharmacol. 2010;159:362-73 pubmed publisher
    ..We investigated the effects of TREK-1 channel blockers on nitrergic neurotransmission in mouse and opossum lower oesophageal sphincter (LOS) circular smooth muscle (CSM)...
  41. Xing J, Lei Y, Chen J. Gastric electrical stimulation (GES) with parameters for morbid obesity elevates lower esophageal sphincter (LES) pressure in conscious dogs. Obes Surg. 2005;15:1321-7 pubmed
    ..Treatment of obese patients with the implantable gastric stimulator (IGS) was reported to improve reflux symptoms, independent of weight loss. We evaluated the effect of gastric electrical stimulation on LES pressure in conscious dogs...
  42. Bektas M, Doganay B, Alkan M, Ustun Y, Soykan I. Esophageal motor function in Familial Mediterranean Fever: a prospective evaluation of motility in 31 patients. Eur J Intern Med. 2009;20:548-50 pubmed publisher
  43. Takeuchi T, Nakamura A, Nakajima H, Azuma Y, Hata F. Inhibitory effects of alendronate on cholinergic responses in rat lower esophageal sphincter. Eur J Pharmacol. 2006;537:155-9 pubmed
    ..we examined the effects of alendronate on electrical field stimulation-induced responses in the rat lower esophageal sphincter. Electrical field stimulation induced atropine-sensitive contraction...
  44. Sanmiguel C, Hagiike M, Mintchev M, Cruz R, Phillips E, Cunneen S, et al. Effect of electrical stimulation of the LES on LES pressure in a canine model. Am J Physiol Gastrointest Liver Physiol. 2008;295:G389-94 pubmed publisher
    Gastric electrical stimulation modulates lower esophageal sphincter pressure (LESP). High-frequency neural stimulation (NES) can induce gut smooth muscle contractions...
  45. D Journo X, Ferraro P, Martin J, Chen L, Duranceau A. Lower oesophageal sphincter dysfunction is part of the functional abnormality in epiphrenic diverticulum. Br J Surg. 2009;96:892-900 pubmed publisher
    ..The pathophysiology and management of epiphrenic diverticula remain controversial. This study investigated the underlying functional abnormalities and long-term results of surgical treatment...
  46. Ahmed W, Vohra E. Esophageal motility disorders in diabetics with and without neuropathy. J Pak Med Assoc. 2006;56:54-8 pubmed
    ..To detect the presence of esophageal motor disorders in diabetic patients, and to establish whether there is any difference between patients with and without neuropathy...
  47. Fass R, Navarro Rodriguez T. Noncardiac chest pain. J Clin Gastroenterol. 2008;42:636-46 pubmed publisher
    ..NCCP patients with or without spastic esophageal motor disorders are responsive to pain modulators. The value of botulinum toxin injection, endoscopic treatment for GERD, and antireflux surgery in alleviating NCCP symptoms is limited...
  48. Dughera L, Cassolino P, Cisarò F, Chiaverina M. Achalasia. Minerva Gastroenterol Dietol. 2008;54:277-85 pubmed
    ..options (pneumatic dilation, surgical myotomy, and pharmacologic agents) aimed at reducing the lower esophageal sphincter (LES) pressure and facilitating esophageal emptying by gravity and hydrostatic pressure of retained food ..
  49. Koshino K, Adachi K, Furuta K, Ohara S, Morita T, Nakata S, et al. Effects of mosapride on esophageal functions and gastroesophageal reflux. J Gastroenterol Hepatol. 2010;25:1066-71 pubmed publisher
    ..The aim of the present study was to determine whether mosapride, a prokinetic agent, stimulates esophageal functions, and prevents acidic and non-acidic gastroesophageal reflux...
  50. Boeckxstaens G. Reflux inhibitors: a new approach for GERD?. Curr Opin Pharmacol. 2008;8:685-9 pubmed publisher
    ..As reflux mainly occurs during transient lower esophageal sphincter relaxations (TLESRs), drugs targeting this motor pattern may be of great interest to further reduce ..
  51. Moazzez R, Bartlett D, Anggiansah A. The effect of chewing sugar-free gum on gastro-esophageal reflux. J Dent Res. 2005;84:1062-5 pubmed
    ..7 (1.7-13.5) and, with chewing gum, 3.6 (0.3-7.3), respectively (p = 0.001). Chewing sugar-free gum for half an hour after a meal can reduce acidic postprandial esophageal reflux...
  52. Boguradzka A, Tarnowski W, Mazurczak Pluta T. [Gastroesophageal reflux disease in hazardous drinkers]. Pol Merkur Lekarski. 2006;21:99-104 pubmed
    ..For identification of hazardous drinking patients we can use AUDIT (Alcohol Use Disorder Identification Test). AUDIT has been created by World Health Organization experts as a simple screening test looking for hazardous drinking people...
  53. Piche T. [Transient lower esophageal sphincter relaxations: therapeutic targets in gastro-esophageal reflux disease]. Gastroenterol Clin Biol. 2004;28:662-72 pubmed