Disruption of primary and secondary esophageal peristalsis by afferent stimulation

Recent studies have shown that afferent signals originating from the pharyn x inhibit progression of primary esophageal peristalsis. Our aim was to fur ther elucidate the effect of esophageal and pharyngeal afferent stimulation on primary and secondary esophageal peristalsis. We studied the effect of esophageal air distension and pharyngeal water stimulation on progression o f primary and secondary peristalsis in nine healthy volunteers aged 27 +/- 2 yr (4 men, 5 women). At a threshold volume, rapid injection of water into the pharynx, directed posteriorly, resulted in complete halt of the progre ssing secondary and primary esophageal peristalses in both the proximal and distal esophagus. The threshold volume of injected water for inducing inhi bition was similar for secondary (0.6 +/- 0.2 ml) and primary (0.5 +/- 0.1 ml) esophageal peristalsis. Progression of primary peristalsis induced by a dry swallow and secondary peristalsis induced by intraesophageal air diste nsion were completely inhibited by intraesophageal injection of 15 +/- 2 ml of air in 70% and 75% of the trials, respectively. We conclude that affere nt signals induced by esophageal air distension and pharyngeal water stimul ation inhibit propagation of both primary and secondary esophageal peristal sis, suggesting a shared neural control mechanism for these types of perist alsis.