Measurement of upper esophageal sphincter pressure. Effect of acute emotional stress.

Recent studies suggest that resting upper esophageal sphincter pressure is more labile than previously thought, being augmented during rapid manometric pull-through and markedly decreased during sleep and anesthesia. The effect of acute emotional stress on resting upper esophageal sphincter pressure was evaluated in 13 normal subjects with a manometric sleeve assembly. Manometric sideholes were positioned in the pharynx and cervical and thoracic esophagus while the sleeve sensor straddled the upper esophageal sphincter. Subjects were stressed intermittently by 14-min periods of a dichotic listening task. As incentive, a financial reward was offered and made commensurate with performance. Alterations of heart rate, blood pressure, and skin conductance confirmed the effectiveness of the stressor. The overall mean upper esophageal sphincter pressure during control periods was 46.5 mmHg (SEM = 4.7). During stress there was a significant mean increase (11.8 +/- 2.9 mmHg; p = 0.002) in upper esophageal sphincter pressure from control levels, and the pressure increase during the first 2-min epoch of stress was 20.8 +/- 3.9 mmHg (p = 0.0003). Emotional stress causes significant elevation of upper esophageal pressure in normal subjects. This effect is likely to influence resting sphincter pressure measurements, particularly if measurement conditions are stressful to the subject.