Efeitos da idade na Motilidade esofagiana: utilização da impedancio manometria de alta resolução.


Effects of age on esophageal motility: use of high-resolution esophageal impedance manometry.

Young Kwang Shim, Nayoung Kim, Yo Han Park, Jong-Chan Lee, Jihee Sung, Yoon Jin Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee1
J Neurogastroenterol Motil 2017; 23: 229-236 DOI : 10.5056/jnm16104

Utilizando manometria de alta resolução os autores demonstram a ocorrência de alterações na motilidade do esôfago conseqüentes ao processo de envelhecimento. É importante observar que o processo normal de envelhecimento provoca tendência à presença de motilidade de esôfago ineficaz, o que tem como conseqüência a menor tolerância a episódios de refluxo gastroesofágico.

Disturbances 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).
Esophageal 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.
Basal 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.
The decrease of UES pressure, distal esophageal motility, and peristaltic velocity might be related with esophageal symptoms in the aged population.