“…DM-induced changes Histology [16][17][18][58][59][60][61][62][63] Increased wall thickness and wall area, muscle hypertrophy, increased collagen fraction in the mucosa-submucosa layer, eosinophilic bodies, upregulated expressions of AGE and RAGE, axonal changes in the extrinsic and intrinsic parasympathetic fibers, degeneration of large myelinated vagal nerve fibers Passive biomechanical properties [16][17][18]32,62,68,73 Increased stiffness of intact wall in all directions, increased circumferential stiffness of mucosa-submucosa layer, decreased opening angle and residual strains, reduced longitudinal shortening and reduced radial stretch during distension Active biomechanical properties (motility) 3,6,[68][69][70][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120] Decreased lower esophageal sphincter tone; increased upper esophageal sphincter tone; decreased esophageal transit; decreased frequency of peristaltic contractions after swallowing; decreased amplitude and velocity of esophageal body contractions; low esophageal peristaltic velocity; increased number of spontaneous and nonpropagating contractions, multipeaked contractions; distension-induced hyperreactivity and impaired coordination of the contractions; impaired relaxation and decreased LES pressure amplitude Sensitivity 13,19,…”