Effect of ageing on the upper and lower oesophageal sphincters

Objective: To determine the effect of ageing on length and resting pressure of the upper and lower oesophageal sphincters (UOSs, LOSs). Background: The effectiveness of upper and lower oesophageal sphincters (UOSs and LOSs, respectively) in the control of retrograde trans-sphincteric flow is influenced by sphincteric pressure and length. Methods: Nine young and nine elderly healthy volunteers were studied. Resting UOS and LOS pressures were measured by sleeve devices and lengths were measured by the station pull-through technique. Results: The length of the UOS high pressure zone in the elderly (2.1 ± 0.7 cm posterior; 1.9 ± 0.1 cm anterior) was significantly shorter than that of the young (2.9 ± 0.1 cm posterior; 3.1 ± 0.2 cm anterior) (P<0.01). Resting UOS pressure in the elderly (42 ±5 mmHg) was significantly lower than that of the young (62 ±7 mmHg) (P< 0.05). The intersphincteric length of the oesophagus in the elderly (21 ± 0.2 cm) was similar to that of the young (21 ± 0.4 cm). Total length of the LOS high pressure zone in the young (4.0 ± 0.1 cm) was similar to that of the elderly (4.1 ± 0.1 cm). LOS resting pressure was similar between young and elderly subjects (17 ± 5 mmHg and 15 ± 3 mmHg, respectively). Conclusions: Ageing affects the UOS and LOS differently. With regard to resting pressure and length, ageing weakens the UOS, but has no significant effect on the LOS. (C) 2000 Lippincott Williams and Wilkins.