Power of esophageal peristalsis can be controlled voluntarily

Article Abstract:

During normal swallowing, a wave of sequential contraction and relaxation (peristalsis) forces foods and liquids through the esophagus to the stomach. It was once thought that upon initiation of a swallow, the peristaltic wave would occur in a preprogrammed fashion that was largely independent of voluntary control. It is now recognized that some aspects of peristalsis, notably the amplitude of the peristaltic wave, are in fact under conscious control. Disturbances in peristalsis are part of the problem underlying several motility-related disorders, and patients suffering from these conditions might possibly benefit from training in the alteration of esophageal peristalsis. To further characterize the degree to which the amplitude of esophageal peristaltic contractions are under voluntary control, six healthy male volunteers and eight otherwise-healthy female patients with angina-like chest pain not attributable to cardiovascular disease (hence, probably related to peristaltic dysfunction) were instrumented for manometric monitoring of esophageal peristalsis. All subjects were asked to take a series of large and small swallows in random order in which either liquid (wet swallow) or nothing (dry swallow) was ingested. The amplitude of the peristaltic contraction was found to be related to the size of the swallow, that is, it was under voluntary control; neither the velocity with which the peristaltic wave was propagated nor the duration of the wave was related to the size of the swallow. Overall, there were no statistically significant differences between patients and volunteers, but several of the patients had very high amplitude peristaltic contractions which are diagnostic of the painful condition known as ''nutcracker'' esophagus; these patients were able to consciously control the amplitude of their peristaltic contractions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Esophagus, Biofeedback training, Biofeedback, Peristalsis, Diffuse esophageal spasm

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Occupational distribution of inflammatory bowel disease among German employees

Article Abstract:

Inflammatory bowel disease is a painful and debilitating class of conditions in which portions of the lower intestine become inflamed and ulcerated, leading to nausea, vomiting, diarrhea, and other symptoms. Perforation of the affected intestinal segment can be fatal. Significant health care expenditures are directed at the care, treatment, and rehabilitation of patients suffering from inflammatory bowel disease. To investigate the distribution of inflammatory bowel disease among workers in West Germany, where the socialized medicine system provides a large database on medical treatment administered to all citizens, records of all patients treated between 1982 and 1988 were analyzed. A total of 12,014 patients were treated for the two most prevalent types of inflammatory bowel disease, Crohn's disease, which affects the ileum, and ulcerative colitis, which affects the colon. Among men, the disease incidence was lower for individuals engaged in physically strenuous work such as bricklaying, road construction, and unskilled labor of various types. A high incidence of the disease was seen among instrument makers, electricians, bakers, and technical assistants. Among women, low rates of inflammatory bowel disease were seen among those involved in cleaning and maintenance professions, or those who stayed at home, while higher rates were associated with professions such as sales representative, hairdresser, and health occupations. These patterns appeared to be stable over the six-year period that was analyzed and suggest that occupations involving physical labor or outdoor work may confer a protective benefit. Conversely, artificial and sedentary working conditions may increase the risk of developing inflammatory bowel disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Germany, Occupational health and safety, Occupational safety and health, Risk factors, Demographic aspects, Environmental aspects, Inflammatory bowel diseases

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