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Lower Esophageal Sphincter: Normal Structure and Function

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Esophageal and Gastric Disorders in Infancy and Childhood

Abstract

The esophagus acts as a conduit for the coordinated transport of food from the mouth to the stomach. Developmentally, it can be identified as a distinct structure from 4 weeks of gestation. At birth, it has a length of approximately 8 cm, which doubles in the first years of extrauterine life. Each of the three germ layers (endoderm, ectoderm, and mesoderm) is responsible for esophageal development, and their interactions are crucial for the development of the mucosa, muscular coats, and intrinsic nervous system.

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References

  1. Mittal RK, Balaban DH. The esophagogastric junction. N Engl J Med. 1997;336:924–32.

    Article  CAS  PubMed  Google Scholar 

  2. Christensen J. Motor function of the pharynx and esophagus. In: Johnson LR, editor. Physiology of the gastrointestinal tract. 2nd ed. New York: Raven Press; 1987. p. 595–612.

    Google Scholar 

  3. Skandalakis JE, Ellis H. Embryologic and anatomic basis of esophageal surgery. Surg Clin N Am. 2000;80:85–155.

    Article  CAS  PubMed  Google Scholar 

  4. Biancani P, Harnett KM, Behar J. Esophageal motor function. In: Yamada T, editor. Textbook of gastroenterology, vol. 1. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 166–92.

    Google Scholar 

  5. Davidson GP, Omari TI. Reflux in children. Baillieres Best Pract Res Clin Gastroenterol. 2000;14:839–55.

    Article  CAS  PubMed  Google Scholar 

  6. Cresi F, de Sanctis L, Savino F, et al. Relationship between gastro-oesophageal reflux and gastric activity in newborns assessed by combined intraluminal impedance, pH metry and epigastric impedance. Neurogastroenterol Motil. 2006;18:361–8.

    Article  CAS  PubMed  Google Scholar 

  7. Goyal RK, Padmanabhan R, Sang Q. Neural circuits in swallowing and abdominal vagal afferent-mediated lower esophageal sphincter relaxation. Am J Med. 2001;111(Suppl 8A):95S–105.

    Article  PubMed  Google Scholar 

  8. Hornby PJ, Abrahams TP, Partosoedarso ER. Central mechanisms of lower esophageal sphincter control. Gastroenterol Clin North Am. 2002;31 Suppl 4:S11–20.

    Article  PubMed  Google Scholar 

  9. Liu J, Parashar VK, Mittal RK. Asymmetry of lower esophageal sphincter pressure: is it related to the muscle thickness or its shape? Am J Physiol. 1997;272:G1509–17.

    CAS  PubMed  Google Scholar 

  10. Goyal RK, Prasad M, Chang HY. Functional anatomy and physiology of swallowing and esophageal motility. In: Castell DO, Richter JE, editors. The esophagus. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 1–36.

    Google Scholar 

  11. Dent J, Dodds WJ, Sekigushi T, et al. Interdigestive phasic contraction of the human lower esophageal sphincter. Gastroenterology. 1983;84:453–60.

    CAS  PubMed  Google Scholar 

  12. McDermott CM, Abrahams TP, Partosoedarso E, et al. Site of action of GABA(B) receptor for vagal motor control of the lower esophageal sphincter in ferrets and rats. Gastroenterology. 2001;120:1749–62.

    Article  CAS  PubMed  Google Scholar 

  13. Yamato S, Saha JK, Goyal RK. Role of nitric oxide in lower esophageal sphincter relaxation to swallowing. Life Sci. 1992;50:1263–72.

    Article  CAS  PubMed  Google Scholar 

  14. Wyman JB, Dent J, Heddle R, et al. Control of belching by the lower oesophageal sphincter. Gut. 1990;31:639–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Mittal RK, Holloway RH, Penagini R, et al. Transient lower esophageal sphincter relaxation. Gastroenterology. 1995;109:601–10.

    Article  CAS  PubMed  Google Scholar 

  16. Holloway RH, Penagini R, Ireland AC. Criteria for the objective definition of transient lower esophageal sphincter relaxation. Am J Physiol. 1994;268:G128–33.

    Google Scholar 

  17. Dodds WJ, Dent J, Hogan WG, et al. Mechanism of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982;307:1547.

    Article  CAS  PubMed  Google Scholar 

  18. Dent J, Dodds WJ, Friedman RH, et al. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects. J Clin Invest. 1980;65:256–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Cucchiara S, Bortolotti M, Minella R, et al. Fasting and postprandial mechanisms of gastroesophageal reflux in children with gastroesophageal reflux disease. Dig Dis Sci. 1993;38:86–92.

    Article  CAS  PubMed  Google Scholar 

  20. Kawahara H, Dent J, Davidson G. Mechanism responsible for gastroesophageal reflux in children. Gastroenterology. 1997;113:399–408.

    Article  CAS  PubMed  Google Scholar 

  21. Hillemeier AC, Grill BB, McCallum R, et al. Esophageal and gastric motor abnormalities in infants with and without gastroesophageal reflux. Gastroenterology. 1983;84:741–6.

    CAS  PubMed  Google Scholar 

  22. Cucchiara S, Staiano A, Di Lorenzo C, et al. Esophageal motor abnormalities in children with gastroesophageal reflux and peptic esophagitis. J Pediatr. 1986;108:907–10.

    Article  CAS  PubMed  Google Scholar 

  23. Newel SJ, Sarkar PK, Durbin GM, et al. Maturation of the lower esophageal sphincter in the preterm baby. Gut. 1988;95:52–62.

    Google Scholar 

  24. Boix-Ochoa J, Canals J. Maturation of the lower esophagus. J Pediatr Surg. 1976;11:749–56.

    Article  CAS  PubMed  Google Scholar 

  25. Omari TI, Barnett C, Snel A, et al. Mechanisms of gastroesophageal reflux in healthy premature infants. J Pediatr. 1998;133:650–4.

    Article  CAS  PubMed  Google Scholar 

  26. Omari TI, Benninga MA, Barnett CP, et al. Characterization of esophageal body and lower esophageal sphincter motor function in the very premature neonate. J Pediatr. 1999;135:517–21.

    Article  CAS  PubMed  Google Scholar 

  27. Omari TI, Barnett CP, Benninga MA, et al. Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease. Gut. 2002;51:475–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Nikhil Thapar MD, PhD .

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Borrelli, O., Thapar, N. (2017). Lower Esophageal Sphincter: Normal Structure and Function. In: Till, H., Thomson, M., Foker, J., Holcomb III, G., Khan, K. (eds) Esophageal and Gastric Disorders in Infancy and Childhood. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11202-7_68

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  • DOI: https://doi.org/10.1007/978-3-642-11202-7_68

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