Peristaltic regimes in esophageal transport

TL;DR

This paper investigates the mechanical and geometric regimes of esophageal peristalsis using a 1D flow model and clinical data, revealing three modes of peristaltic behavior with implications for understanding esophageal function.

Contribution

It introduces a parametric analysis of esophageal peristaltic regimes using a 1D elastic tube model, linking mechanical properties to flow patterns and clinical observations.

Findings

Identified three peristaltic regimes, with two being physiologically relevant.

Quantified effects of tube stiffness, fluid density, and contraction strength on esophageal shape.

Revealed the mechanics behind contraction opening as a function of flow resistance.

Abstract

A FLIP device gives cross-sectional area along the length of the esophagus and one pressure measurement, both as a function of time. Deducing mechanical properties of the esophagus including wall material properties, contraction strength, and wall relaxation from these data is a challenging inverse problem. Knowing mechanical properties can change how clinical decisions are made because of its potential for in-vivo mechanistic insights. To obtain such information, we conducted a parametric study to identify peristaltic regimes by using a 1D model of peristaltic flow through an elastic tube closed on both ends and also applied it to interpret clinical data. The results gave insightful information about the effect of tube stiffness, fluid/bolus density and contraction strength on the resulting esophagus shape through quantitive representations of the peristaltic regimes. Our analysis also revealed the mechanics of the opening of the contraction area as a function of bolus flow resistance. Lastly, we concluded that peristaltic driven flow displays three modes of peristaltic geometries, but all physiologically relevant flows fall into two peristaltic regimes characterized by a tight contraction.