Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise

Reza Shaker, Mark Kern, Eytan Bardan, Andrew Taylor, Edward T. Stewart, Raymond G. Hoffmann, Ronald C. Arndorfer, Candy Hofmann, Jodie Bonnevier

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187 Scopus citations


Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P < 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham- exercise) subjects (P < 0.05). A similar effect was not found in the sham- exercise group. In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening.

Original languageEnglish (US)
Pages (from-to)G1518-G1522
JournalAmerican Journal of Physiology - Gastrointestinal and Liver Physiology
Issue number6 35-6
StatePublished - Jun 1997


  • Aging
  • Dysphagia
  • Swallowing disorders
  • Upper esophageal sphincter


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