Cholinergic stimulation induces asynchrony between the circular and longitudinal muscle contraction during esophageal peristalsis

摘要

Patients with high-amplitude esophageal contractions (nutcracker esophagus, a form of primary motor disorder of the esophagus) demonstrate asynchrony of contraction of the two muscle layers. The peak LM contraction occurs earlier than the peak CM contraction during peristalsis in these patients (4). Primary motor disorders of the esophagus are presently best explained on the basis of an imbalance between inhibitory and excitatory innervation of the lower esophageal sphincter (LES) and esophagus (1, 15, 16, 18). It is felt that an unopposed excitatory innervation leads to high amplitude contraction of the nutcracker esophagus.