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Physiology of esophageal motor function.

N E Diamant1

  • 1University of Toronto, Ontario.

Gastroenterology Clinics of North America
|June 1, 1989
PubMed
Summary

The central nervous system and peripheral nerves coordinate esophageal muscle activity. Central control mechanisms primarily influence excitatory cholinergic neurons for peristalsis and lower esophageal sphincter function.

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Area of Science:

  • Gastroenterology
  • Neuroscience
  • Physiology

Background:

  • The esophagus comprises three functional zones: upper and lower esophageal sphincters and the esophageal body.
  • Esophageal function involves intricate coordination of voluntary and involuntary control mechanisms, integrating striated and smooth muscle activity.
  • The distal esophagus in humans is primarily smooth muscle, with extrinsic control originating from a brainstem swallowing center.

Purpose of the Study:

  • To elucidate the neural control mechanisms governing esophageal motor function, including peristalsis and sphincter activity.
  • To detail the roles of central and peripheral nervous systems in coordinating esophageal motility.
  • To investigate the specific neural pathways and neurotransmitters involved in esophageal muscle contraction and relaxation.

Main Methods:

  • Review of existing literature on esophageal innervation and control.
  • Analysis of the roles of the vagus nerve, sympathetic pathways, and intramural nerve plexuses.
  • Examination of the function of excitatory cholinergic and nonadrenergic, noncholinergic (NANC) inhibitory neurons in smooth muscle.

Main Results:

  • Esophageal motor function is controlled by a brainstem swallowing center with afferent, efferent, and internuncial systems.
  • Vagal nerve fibers innervate both striated and smooth muscle, including sphincters.
  • In the smooth muscle esophagus, peristalsis is primarily mediated by sequential activation of intramural excitatory cholinergic neurons, influenced by central control.

Conclusions:

  • Central neural control mechanisms exert dominant influence on esophageal peristalsis and lower esophageal sphincter tone.
  • Swallow-induced esophageal peristalsis in humans is cholinergic, driven by intramural excitatory neurons.
  • Lower esophageal sphincter resting tone is cholinergic, regulated by a balance of excitatory and inhibitory influences, with relaxation mediated by NANC neurons.

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