Characterization of esophageal body and lower esophageal sphincter motor function in the very premature neonate

J Pediatr. 1999 Oct;135(4):517-21. doi: 10.1016/s0022-3476(99)70178-2.


Objectives: To characterize esophageal body and lower esophageal sphincter (LES) motor function in very premature infants.

Study design: Esophageal manometry was performed in 12 very premature infants of 26 to 33 weeks' postmenstrual age (PMA) (body weights of 610-1360 g). Esophageal motor patterns were recorded for 30 minutes with a perfused micromanometric sleeve assembly (outer diameter, 2.0 mm).

Results: Esophageal pressure waves triggered by dry swallows were predominantly (84%) peristaltic in propagation sequence. All infants showed tonic LES contraction; the mean resting LES pressure (LESP) for individual infants ranged from 5.0 +/- 4.1 mm Hg to 20.0 +/- 4.8 mm Hg. In all infants the LES relaxed (duration, 5.8 +/- 3.0 seconds; nadir pressure, 1.8 +/- 2.6 mm Hg) in response to pharyngeal swallows. Transient LES relaxations (TLESRs) (duration, 21.7 +/- 8.7 seconds; nadir pressure, 0.1 +/- 1.8 mm Hg) occurred on average 2.6 +/- 1.6 times per study; 86% of these relaxations triggered esophageal body common cavity events known to be associated with gastroesophageal reflux.

Conclusions: Esophageal motor function is well developed in very premature infants. Our data also suggest that TLESR is the predominant mechanism of reflux in these babies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Esophagogastric Junction / physiology
  • Esophagus / physiology*
  • Humans
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Infant, Very Low Birth Weight
  • Manometry
  • Muscle Contraction
  • Peristalsis
  • Pressure