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Human esophageal motor function develops after birth, with the upper esophageal sphincter (UES) mature early. The lower esophageal sphincter (LES) shows significant postnatal changes, but its dysfunction link to infant reflux remains unclear.
Area of Science:
- Pediatric Gastroenterology
- Developmental Physiology
Background:
- Esophageal motor function development in humans is not well understood.
- Anatomical growth of the esophagus and sphincters occurs postnatally.
Purpose of the Study:
- To review the developmental trajectory of human esophageal motor function.
- To elucidate the maturation of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES).
Main Methods:
- Literature review of studies on infant esophageal motility.
- Analysis of data on UES and LES pressure and function development.
Main Results:
- The UES is developed at birth with minimal postnatal functional maturation.
- Esophageal body sucking and swallowing mature rapidly in term infants, slower in premature infants.
- The LES pressure is low at birth, rises above adult levels by 6 months, then decreases to adult levels by 1-3 years, suggesting bulk increase.
Conclusions:
- Postnatal development of esophageal motor function varies between sphincters and the esophageal body.
- Further research is needed to assess neural maturation and muscle responsiveness of the LES.
- The connection between LES dysfunction, infant gastroesophageal reflux, and pulmonary issues requires further investigation.
Abstract:
There is limited information on the developmental aspects of esophageal motor function in humans. Length of the esophageal body and its sphincters increases progressively after birth. The UES is well developed at birth, and except for a slight pressure increase during the first year, there is little evidence of functional maturation postnatally. Within the esophageal body, the sucking and swallowing patterns mature within a few days in term infants, whereas this maturation takes longer in premature infants. In the LES, pressures may be low at birth but thereafter rise above adult levels until 6 months of age, to slowly decrease to adult levels by 1 to 3 yr of age. Maturation of the LES reflects at least an increase in bulk, although neural maturation and maturation of muscle responsiveness require further assessment in humans. The relationship of LES dysfunction to gastroesophageal reflux in infants is still not elucidated. The relationship of gastroesophageal reflex to pulmonary problems is similarly uncertain.