Esophageal motility

Goyal, Raj K.; Paterson, William G.

doi:10.1002/cphy.cp060122

Cited by 51 publications

(58 citation statements)

References 412 publications

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“…interstitial cells of Cajal; Ca 2ϩ imaging; electrophysiology; nitric oxide THE LOWER ESOPHAGEAL SPHINCTER (LES) is a specialized circular smooth muscle (CSM) that maintains tonic contraction at rest and thereby serves as a pressure barrier that prevents reflux of gastric contents into the esophagus. Swallowing induces relaxation of the LES via vagal efferent neurons, which activate inhibitory motor neurons within the myenteric plexus (12). These intrinsic neurons in turn primarily release nitric oxide (NO), which relaxes the LES CSM (26,35).…”

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confidence: 99%

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice

Bautista-Cruz

Paterson

2011

American Journal of Physiology-Gastrointestinal and Liver Physi

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Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice

Bautista-Cruz

Paterson

2011

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…These unique characteristics include the following. 1) The retrograde contraction is ϳ10 times faster than secondary peristalsis (9). 2) The shape of the retrograde contraction, as opposed to secondary peristalsis, depends on the stimulus.…”

Section: Discussionmentioning

confidence: 99%

Digestive and respiratory tract motor responses associated with eructation

Lang

Medda

Shaker

2013

American Journal of Physiology-Gastrointestinal and Liver Physi

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Lang IM, Medda BK, Shaker R. Digestive and respiratory tract motor responses associated with eructation. Am J Physiol Gastrointest Liver Physiol 304: G1044 -G1053, 2013. First published April 11, 2013 doi:10.1152/ajpgi.00043.2013.-We studied the digestive and respiratory tract motor responses in 10 chronically instrumented dogs during eructation activated after feeding. Muscles were recorded from the cervical area, thorax, and abdomen. The striated muscles were recorded using EMG and the smooth muscles using strain gauges. We found eructation in three distinct functional phases that were composed of different sets of motor responses: gas escape, barrier elimination, and gas transport. The gas escape phase, activated by gastric distension, consists of relaxation of the lower esophageal sphincter and diaphragmatic hiatus and contraction of the longitudinal muscle of the thoracic esophagus and rectus abdominis. All these motor events promote gas escape from the stomach. The barrier elimination phase, probably activated by rapid gas distension of the thoracic esophagus, consists of relaxation of the pharyngeal constrictors and excitation of dorsal and ventral upper esophageal sphincter distracting muscles, as well as rapid contraction of the diaphragmatic dome fibers. These motor events allow esophagopharyngeal air movement by promoting retrograde airflow and opening of the upper esophageal sphincter. The transport phase, possibly activated secondary to diaphragmatic contraction, consists of a retrograde contraction of the striated muscle esophagus that transports the air from the thoracic esophagus to the pharynx. We hypothesize that the esophageal reverse peristalsis is mediated by elementary reflexes, rather than a coordinated peristaltic response like secondary peristalsis. The phases of eructation can be activated independently of one another or in a different manner to participate in physiological events other than eructation that cause gastroesophageal or esophagogastric reflux.belching; gastrointestinal motor activity; pharynx; larynx; esophagus SOME OF THE MOTOR EVENTS associated with eructation are known, i.e., upper and lower esophageal sphincter (UES and LES) relaxation (13,15,16,(23)(24)(25)31), glottal closure (26), changes in respiration (11,22), and retrograde esophageal peristalsis (11), but the specific muscles that accomplish these functions are unknown or incompletely known. Other functions during eructation, e.g., opening of the UES, have not been investigated. Moreover, while some of the motor responses during eructation have been identified, as noted above, most studies focused on only one muscle or function, and the relationship among functions and motor responses producing the effects of eructation has not been investigated. Therefore, while it has been determined that transient LES relaxation (TLESR), as well as relaxation of the UES, is associated with eructation (23), the relationship between TLESR and UES relaxation during eructation is unknown.

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“…Despite decades of sophisticated study, there is controversy over precisely which muscles comprise the UES [6]. The location and structure of the cricopharyngeus muscle appears well suited to sphincter function, and conventional wisdom holds that the cricopharyngeus is the major muscle of the UES.…”

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“…The sphincter relaxes with deglutition to allow a swallowed bolus to enter the esophagus [5,8]. The sphincter also relaxes during belching and vomiting to allow the egress of air and other material from the esophagus into the mouth [6,9]. Dysfunction of the UES is thought to cause the symptoms of dysphagia and globus [ 10,11], and has been implicated in the pathogenesis of several disorders including Zenker's diverticulum and cricopharyngeal bar [ 12,13].…”

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“…Functionally, the upper esophageal sphincter (UES) is recognized manometrically as a zone of high pressure, 3-4 cm in length, that separates the atmospheric pressure in the pharynx from the subatmospheric pressure in the cervical esophagus [5,6]. This sphincter normally remains closed and prevents air from entering the gastrointestinal tract during inspiration, and protects the airway by preventing material in the esophagus from refluxing back into the pharynx [7].…”

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The role of cricopharyngeus muscle in pharyngoesophageal disorders

et al. 1993

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The cricopharyngeus muscle is generally thought to be responsible for the high pressure zone of the pharyngoesophageal (upper esophageal) sphincter. In this review we critically examined the evidence for the role of the cricopharyngeus muscle in the manometric pharyngoesophageal sphincter. The available studies show disparities between the anatomic location of the cricopharyngeus muscle and the manometric high pressure zone of the pharyngoesophageal sphincter. The cricopharyngeus muscle seems to correspond to the distal 1/3 of the sphincteric high pressure zone and the peak high pressure zone appears to be located proximal to the cricopharyngeus muscle. The discrepancy between the upper high pressure zone and the anatomic cricopharyngeus is important in understanding the role of the cricopharyngeus muscle in the pathophysiology and treatment of clinical disorders of the pharyngoesophageal sphincter.

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Esophageal motility

Cited by 51 publications

References 412 publications

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice

Digestive and respiratory tract motor responses associated with eructation

The role of cricopharyngeus muscle in pharyngoesophageal disorders

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Esophageal motility

Cited by 51 publications

References 412 publications

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/Wvmutant mice

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/Wvmutant mice

Digestive and respiratory tract motor responses associated with eructation

The role of cricopharyngeus muscle in pharyngoesophageal disorders

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Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice

Evidence for altered circular smooth muscle cell function in lower esophageal sphincter ofW/W^vmutant mice